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The surgeon, eager to make an experiment, takes away matter, inoculates, produces a sore, uneasiness in the axilla, and perhaps some affection of the system. This is one way in which a fallacious idea of security both in the mind of the inoculater and the patient may arise; for a disease may thus have been propagated from a simple eruption only.
The disease went through its course without any deviation from its usual habits; and, notwithstanding this, the cow-pox virus excited its common appearances, both on the arm and on the constitution, without any febrile interruption; on the sixth day there was a vesicle. 8th: Pain in the axilla, chilly, and affected with headache. 9th: Nearly well.
The scab continued to spread and increase in thickness for some days, when, at its edges, a vesicated ring appeared, and the disease went through its ordinary course, the boy having had soreness in the axilla and some slight indisposition. With the fluid matter taken from his arm five persons were inoculated. In one it took no effect.
#Wounds# of veins punctured and incised frequently occur in the course of operations; for example, in the removal of tumours or diseased glands from the neck, the axilla, or the groin. They are also met with as a result of accidental stabs and of suicidal or homicidal injuries.
The infection rarely spreads to the lymphatics, but we have seen inoculation tubercle of the index-finger followed by a large cold abscess on the median side of the upper arm and by a huge mass of breaking down glands in the axilla.
The infective agent, moreover, in order to reach the blood stream, must usually overcome the resistance of several glands. Lymph glands are, for the most part, arranged in groups or chains, such as those in the axilla, neck, and groin.
The first was that of a young lady, who, after ten years' suppression of the menstrual discharge, exhibited the flow from a vesicular eruption on the finger. The other case was quite peculiar, the woman being a prostitute, who menstruated from time to time through spots, the size of a five-franc piece, developing on the breasts, buttocks, back, axilla, and epigastrium.
All over the thickened and reddened surface were scattered crops of vesicles and boils. The nails were deformed, and the toes beyond the nails were tense with a serous accumulation. The glands in the right axilla and the groin were much enlarged. The hair on the pubes had disappeared. The abdomen was in a condition similar to that upon the limbs, but less in degree.
In the neck, axilla, and pubes a diffuse overgrowth of the subcutaneous fat is sometimes met with, forming symmetrical tumour-like masses, known as diffuse lipoma. As this is not, strictly speaking, a tumour, the term diffuse lipomatosis is to be preferred. A similar condition was described by Jonathan Hutchinson as being met with in the domestic animals.
If this method fails, a long crutch-like stick is prepared to receive at one end the axillary pad, the patient is placed standing upon a box or bench, the pad and crutch adjusted in the axilla, and while the surgeon stands ready to guide the dislocated bone to its place, his assistants remove the bench, leaving the patient suspended by his shoulder upon the rude crutch.
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