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The formation of pus under these conditions may not be attended with any of the usual signs of suppuration, and beyond some induration around the wound and a slight tenderness on pressure there may be nothing to suggest the presence of an abscess. Acute Suppuration of a Mucous Membrane.
He said he had been round to consult with our physician, who assured him that he had seen hundreds of cases like mine, not one of which terminated in cancer; that such glandular obstructions were common, and might, under certain circumstances, unless great care were used, cause inflammation and suppuration; but were no more productive of cancer, a very rare disease, and consequent upon hereditary tendencies, than were any of the glandular obstructions or gatherings in other parts of the body.
Nor was the treatment of plague-patients in Avignon by any means objectionable; for, after the usual depletions by bleeding and aperients, where circumstances required them, they endeavoured to bring the buboes to suppuration; they made incisions into the inflammatory boils, or burned them with a red-hot iron, a practice which at all times proves salutary, and in the Black Plague saved many lives.
Abscess formation or suppuration should be promptly treated by opening and treating the abscesses. If gangrene occurs, it may be necessary to remove a part, or the whole of the udder. The giving of milk discolored with blood may be treated by applying camphorated ointment twice daily.
MacCormac reports a case of a boy of nine who was run over by a carriage drawn by a pair of horses. He suffered fracture of the base of the skull, of the bones of the face, and of the left ulna, and although suppuration at the points of fracture ensued, followed by an optic neuritis, an ultimate recovery was effected.
The membrane begins to break down and peel off the throat, the temperature goes down, the headache disappears, the swelling in the glands of the neck may either subside or go on to suppuration and rupture, but within another week the child is fairly on the way to recovery. Should the invaders, however, have secured a foothold in the larynx, then the picture is sadly different.
Should this particular branch of the subject yield all that it promises, should it turn out on further trial that when the knot is applied on the antiseptic principle, we may calculate as securely as if it were absent on the occurrence of healing without any deep- seated suppuration, the deligation of main arteries in their continuity will be deprived of the two dangers that now attend it, viz., those of secondary haemorrhage and an unhealthy state of the wound.
Acute Suppuration in a Wound. If in the course of an operation infection of the wound has occurred, a marked inflammatory reaction soon manifests itself, and the same changes as occur in the formation of an acute abscess take place, modified, however, by the fact that the pus can more readily reach the surface. In from twenty-four to forty-eight hours the patient is conscious of a sensation of chilliness, or may even have a rigor. At the same time he feels generally out of sorts, with impaired appetite, headache, and it may be looseness of the bowels. His temperature rises to 100° or 101°
The only significance of it in man is that not infrequently a cherry-stone or some other hard and indigestible matter penetrates into its narrow cavity, and by setting up inflammation and suppuration causes the death of otherwise sound men. Teleology has great difficulty in giving a rational explanation of, and attributing to a beneficent Providence, this dreaded appendicitis.
Indeed, such a procedure would be objectionable, as it would stimulate the pyogenic membrane to unnecessary suppuration. All that is requisite is to guard against the introduction of living atmospheric germs from without, at the same time that free opportunity is afforded for the escape of the discharge from within.
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