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Updated: May 10, 2025
In the majority of cases, fortunately, the peritoneal fire brigade acts promptly, pours out a wall of exudate, and locks up the appendix in a living prison, to fight out its own battles and sink or swim by itself.
Portal depletion is of great advantage, especially if the amount of liquid ingested is kept as low as possible, so that the blood vessels may become thirsty and thus tend to absorb an exudate wherever they find it. Much harm has been done, however, and death has been caused by saline purgatives in endeavoring to relieve edemas from a failing heart or to prevent a uremia from kidney inflammation.
A substance that is absorbable, such as catgut or fine silk, is surrounded and permeated by the phagocytes, which soften and disintegrate it, the debris being gradually absorbed in much the same manner as a fibrinous exudate.
The result of an inflammation of the pericardium may be a fibrous exudate, or an exudate which is both serous and fibrous, or one in which pus is present in considerable amount. The onset of pericarditis may be more or less acute, or it may commence insidiously.
In a small number there is an abundant serous exudate, and with this there may be a considerable formation of fibrin, covering the surface of the membrane and floating in the fluid as flakes or masses; under the influence of movement it may assume the shape of melon-seed bodies. More rarely the joint contains pus, and the surface of the synovial membrane resembles the wall of a cold abscess.
Iron is early indicated, and nothing is better than 5 drops of the tincture of chlorid of iron in a little lemonade or orangeade, administered once in eight hours. If the exudate tends to decrease, it perhaps may be hastened by the local application of tincture of iodin over the cardiac region. Also the administration of small doses of an iodid, as 0.3 gm.
In more severe infections the exudate consists of pus mixed with fibrin, and, it may be, red blood corpuscles purulent or suppurative synovitis; the synovial membrane and the ligaments are softened, and the surface of the membrane presents granulations resembling those on an ulcer; foci of suppuration may develop in the peri-articular cellular tissue and result in abscesses.
For this reason, during severe illness, and especially in those diseases which are known to have pericarditis often as a sequence, frequent examination of the heart should be made as a routine procedure. If there is pain or much aching in the cardiac region, it tends to disappear with the exudate, if such is to occur, in the same way as does the pain of pleurisy.
The commoner pyogenic diseases are the result of infection of one or other of the joint structures with staphylococci or streptococci, which may be demonstrated in the exudate in the joint and in the substance of the synovial membrane. The mode of infection is the same as in the pyogenic diseases of bone, the metastasis occurring most frequently from the mucous membrane of the pharynx (J.
The frequence with which ergot should be so administered depends on the results and the indications. Once in twelve hours for several doses is generally the best method for its use. The Exudate.
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