A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
1. The inflammation may terminate in resolution (Trousseau).
2. The abscess is opened by operation or spontaneously and the patient
recovers.
3. Although the abscess is opened either by the surgeon or
spontaneously, the suppurative process continues and the patient dies
exhausted, usually with waxy viscera.
4. Perforation into the peritoneum, the pleura, or the lung causes
death.
TREATMENT.--The main point in treatment is to discover the abscess and
to open it. The longer the suppurative process goes on and the larger
the abscess, so much the worse is the prognosis. It is proper to
explore with the aspirator after the disease has lasted for a few days,
even if no fluctuation can be made out. The abscess is to be opened and
treated on antiseptic principles.
{104}
HÆMATURIA AND HÆMOGLOBINURIA OR HÆMATINURIA.
BY JAMES TYSON, A.M., M.D.
The above terms are applied, the first to a condition of urine in
which, of the constituents of blood, red discs at least are present;
the second to that in which, while no corpuscles are found, blood
coloring matter is abundant. Each of these conditions has been
repeatedly observed as a distinct state at the moment when urine is
passed; but it is also to be remembered that a true hæmaturia may, in
the course of a few hours, become a hæmatinuria or hæmoglobinuria, by
solution or disintegration of the red blood-discs. So far as I know,
this subsequent solution and conversion can take place only in an
alkaline urine; but as any urine through decomposition may become
alkaline, it is evident that any hæmaturia may, in the course of time,
become a hæmoglobinuria--a fact sometimes overlooked. I have, for
example, known urine to be sent from Southern parts of the United
States which, when shipped, contained blood-corpuscles, but which, when
received in Philadelphia, contained no blood-discs, only large amounts
of blood coloring matter. Especially does this occur in warm weather,
when urine decomposes quickly. Such a hæmoglobinuria might be
characterized as secondary. Doubtless, too, a more rapid solution is
contributed to in some instances by the state of the blood-discs
themselves, which are at times disintegrated before or at the moment
they leave the blood-vessels, at others are intact, and at others,
still, may be just ready to fall to pieces. In the hæmoglobinuria,
where the blood-corpuscles have been secondarily dissolved and
disintegrated, their remnants may be found in the shape of dark-brown
or red granules, which form a sediment of varying bulk.
The immediate cause of this dissolved state of the blood-discs, where
not due to the solvent action of an alkaline urine, appears to be the
difference in degree of the cachexia which is at the bottom of the
renal hemorrhagic tendency.
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