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It is safe to prognose obstruction when the vomiting is severe; but if the nausea continues longer than three days, it must be due to eating or to drugs, to taking too much water while there is nausea, or there is more obstruction than can be accounted for by such diseases as suppurative inflammation of the cecum or appendix.
The characteristic throbbing pulse is, however, easily recognized in most cases. Temperature is variable, though usually elevated from one to four degrees above normal. This symptom varies with the type and stage of the affection. In a subject that has been down, unable to rise for several days, where there is a suppurative and sloughing condition of the laminae, the temperature is high.
In order to relieve the pressure over the inflamed part, the animal stands with the foot slightly flexed at the fetlock. The lameness is not characteristic. It is only by a local examination of the foot, made by pressing on the sole or cutting away the horn, that we are able to form a positive diagnosis. We describe the diseased changes by using the terms dry, moist and suppurative corns.
It occurs in typhoid fever, especially in the later stages of the disease, in tuberculous lesions unaccompanied by suppuration, in malaria, and in most cases of uncomplicated influenza. The occurrence of leucocytosis in any of these conditions is to be looked upon as an indication that a mixed infection has taken place, and that some suppurative process is present.
Prescott reports a case of what he calls fatal colic from the lodgment of a chocolate-nut in the appendix; and Noyes relates an instance of death in a man of thirty-one attributed to the presence of a raisin-seed in the vermiform appendix. Needles, pins, peanuts, fruit-stones, peas, grape-seeds, and many similar objects have been found in both normal and suppurative vermiform appendices.
Its occurrence may be inferred, if in the course of a suppurative lesion there is a sudden rise of temperature, with pain, redness, and swelling along the line of a venous trunk, and a rapidly developed œdema of the limb, with pitting of the skin on pressure. In rare cases a localised abscess forms in the vein and points towards the surface. Treatment.
If the changes in lactic, alcoholic and butyric fermentations are due to minute living organisms, why should not the same tiny creatures make the changes which occur in the body in the putrid and suppurative diseases?
Subcutaneous Whitlow. In this variety the infection manifests itself as a cellulitis of the pulp of the finger (Fig. 9, c), which sometimes spreads towards the palm of the hand. The finger becomes red, swollen, and tense; there is severe throbbing pain, which is usually worst at night and prevents sleep, and the part is extremely tender on pressure. When the palm is invaded there may be marked œdema of the back of the hand, the dense integument of the palm preventing the swelling from appearing on the front. The pus may be under such tension that fluctuation cannot be detected. The patient is usually able to flex the finger to a certain extent without increasing the pain a point which indicates that the tendon sheaths have not been invaded. The suppurative process may, however, spread to the tendon sheaths, or even to the bone. Sometimes the excessive tension and virulent toxins induce actual gangrene of the distal part, or even of the whole finger. There is considerable constitutional disturbance, the temperature often reaching 101° or 102°
The shadow of the new case or involucrum with its wavy contour is also in evidence, with its openings or cloacæ, and is mainly responsible for the increase in the diameter of the bone. The skiagram may also show separation and displacement of the adjacent epiphysis and destruction of the articular surfaces or dislocation of the joint. Sequelæ of Acute Suppurative Osteomyelitis.
This organism has been found in pure culture in suppurative conditions of bone, of cellular tissue, and of internal organs, especially during convalescence from typhoid fever. Like the staphylococcus, it is capable of lying latent in the tissues for long periods. Other Pyogenic Bacteria.
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