A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
The smaller lymph-spaces of the connective tissue in various parts of
the body are the frequent seat of the inflammatory oedema, so called,
whose presence is an important indication of the direction assumed by
a {48} spreading inflammation, as well as a suggestion of the frequent
virulence of its cause.
In general, the serous inflammations are to be regarded as less severe
than other varieties, or as representing an early stage of what later
may be otherwise characterized by a change in the nature of the
products.
The purulent variety of inflammation is present when the exudation is
abundantly cellular. As has already been stated, such cells are, for
the most part, white blood-corpuscles. The purulent exudation, like
the serous variety, may appear either on surfaces, when the term
secretion is applied, or within the lymph-spaces of the connective
tissue over a considerable space, when the pus is said to be
infiltrated. When the infiltration is more circumscribed and the walls
of the affected lymph-spaces are destroyed, so that adjoining cavities
are thrown into larger holes, an abscess is present, from whose wall
pus is constantly derived, while the inflammation is progressive.
The attention of the surgeon, in particular, has been directed to the
isolation of the immediate cause of suppurative inflammation, and the
modern, antiseptic, treatment of wounds is essentially based upon the
view of the infectious origin of pus. The frequent presence of
microbia in purulent exudation where no precautions are taken to
exclude their admission, and their frequent absence or presence in
minute quantities where such precautions are taken, have suggested
that through their influence an inflammatory exudation is likely, if
not actually compelled, to become purulent.
Whether the microbia or their products are the cause of most
suppurative inflammations may be regarded as an open question. It is
generally admitted, however, that, as a rule, an inflammation becomes
purulent in consequence of the presence of an infective agent; in
other words, that most pus is of an infectious origin and possesses
infectious attributes. The labors of Lister in insisting upon the
exclusion of all possible putrefactive agencies in the treatment of
wounds have met with universal approval, and the basis of his
treatment remains fixed, although different methods have been devised
for its enforcement. His researches, and those stimulated by his work,
have resulted in the establishment of principles which affect the
whole field of theoretical as well as practical medicine.
Although most pus may be considered as due to the action of a virus
introduced from without, and capable of indefinite progressive
increase within the body, all pus is not to be regarded as of
infectious origin. There are pyrogenetic agencies, like petroleum,
turpentine, and croton oil, which, introduced into the body, produce
suppurative inflammation without the association of microbia.
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