The symptoms attendant on suppuration vary much according to the
nature of the parts involved. In general, it is accompanied with the
subsidence of acute pain and fever; but, in unyielding textures, the
increase of swelling, by the formation of purulent matter, is often
attended with an aggravation of the symptoms, and with an increase
of danger to the structures affected. The pain which accompanies
suppuration is dull, and attended with a sensation of fulness and
throbbing, and an increase of the tumour; ultimately the parietes
of the abscess become absorbed, and the collection, being more
superficial, the most careless observer must be convinced of its
existence, by the less equivocal signs of fluctuation and pointing.
In general, especially when the abscess is deeply seated, a greater
or less degree of œdema surrounds it, producing a soft pitting
tumour; but not unfrequently, when the degree of excitement is more
intense, lymph, instead of serum, is effused, rendering the part more
hard and resisting: in such cases it may be difficult to discover
the existence of purulent matter, and the tactus eruditus, as it is
called, will be found of material service; for, though pus is neither
acrid nor corroding, still, if allowed to remain for any long period,
much mischief may be caused—the bones may become diseased—muscles
and tendons may slough—and the matter may discharge itself, by means
of ulceration, into certain cavities and canals, and produce very
serious consequences. Of the bad effects produced by the pressure and
irritation of extensive and undisturbed collections of purulent matter,
every practitioner must have seen numerous examples. Still, through
prejudice, erroneously conceived opinions, or servile imitation, the
greatest dread seems, with many, to exist of the practice of giving a
free exit to the contents of such depôts.
The symptoms and sensible signs of suppuration are usually preceded
by shivering, recurring at intervals, and commonly terminating in
profuse perspiration. But this is by no means an unequivocal sign of
the occurrence of suppuration; and this process very often takes place
without any feeling of rigor.
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