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Updated: May 1, 2025
Leucocytosis is met with in nearly all acute infective diseases, and in acute pyogenic inflammatory affections, particularly in those attended with suppuration. In exceptionally acute septic conditions the extreme virulence of the toxins may prevent the leucocytes reacting, and leucocytosis may be absent. The absence of leucocytosis in a disease in which it is usually present is therefore to be looked upon as a grave omen, particularly when the general symptoms are severe. In some cases of malignant disease the number of leucocytes is increased to 15,000 or 20,000. A few hours after a severe hæmorrhage also there is usually a leucocytosis of from 15,000 to 30,000, which lasts for three or four days (Lyon). In cases of hæmorrhage the leucocytosis is increased by infusion of fluids into the circulation. After all operations there is at least a transient leucocytosis (post-operative leucocytosis) (F.
In those days few wounds escaped the ravages of pyogenic and other bacteria, with the result that suppuration ensued after most operations, and such diseases as erysipelas, pyæmia, and "hospital gangrene" were of everyday occurrence.
Another group is that in which chronic inflammation is due to mild or attenuated forms of pyogenic infection affecting especially the lymph glands and the bone marrow.
So long as the tissues are in a healthy condition they are able to withstand the attacks of moderate numbers of pyogenic bacteria of ordinary virulence, but when devitalised by disease, by injury, or by inflammation due to the action of other pathogenic organisms, suppuration ensues.
The term sepsis as now used in clinical surgery no longer retains its original meaning as synonymous with "putrefaction," but is employed to denote all conditions in which bacterial infection has taken place, and more particularly those in which pyogenic bacteria are present.
The retro-pharyngeal glands lie on each side of the median line upon the rectus capitis anticus major muscle and in front of the pre-vertebral layer of the cervical fascia. When they are infected with pyogenic organisms or with tubercle bacilli, they may lead to the formation of one form of retro-pharyngeal abscess.
PYOGENIC DISEASES OF BONE. These diseases result from infection with pyogenic organisms, and two varieties or types are recognised according to whether the organisms concerned reach their seat of action by way of the blood-stream, or through an infection of the soft parts in contact with the bone.
The femoral glands lie vertically along the upper part of the great saphenous vein, and receive lymph from the leg and foot; from them the lymph passes to the deep inguinal and external iliac glands. The femoral glands often participate in pyogenic infections entering through the skin of the toes and sole of the foot. The lymph passes on to the deep inguinal and external iliac glands.
The pyogenic membrane, like the granulations of a sore, which it resembles in nature, forms pus, not from any inherent disposition to do so, but only because it is subjected to some preternatural stimulation. In an ordinary abscess, whether acute or chronic, before it is opened the stimulus which maintains the suppuration is derived from the presence of pus pent up within the cavity.
Many surgeons advise that so long as the abscess is quiescent it should be left alone. All agree, however, that if it shows a tendency to spread, to increase in size, or to approach the skin or a mucous membrane, something should be done to avoid the danger of its bursting and becoming infected with pyogenic organisms.
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