Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
_Treatment._--When the symptoms have once developed they can only be
palliated. The patient must be kept absolutely quiet and free from all
sources of irritation. The spasms may be diminished by means of chloral
and bromides, or by chloroform inhalation.
ANTHRAX
Anthrax is a comparatively rare disease, communicable to man from
certain of the lower animals, such as sheep, oxen, horses, deer, and
other herbivora. In animals it is characterised by symptoms of acute
general poisoning, and, from the fact that it produces a marked
enlargement of the spleen, is known in veterinary surgery as "splenic
fever."
The _bacillus anthracis_ (Fig. 27), the largest of the known pathogenic
bacteria, occurs in groups or in chains made up of numerous bacilli,
each bacillus measuring from 6 to 8 µ in length. The organisms are found
in enormous numbers throughout the bodies of animals that have died of
anthrax, and are readily recognised and cultivated. Sporulation only
takes place outside the body, probably because free oxygen is necessary
to the process. In the spore-free condition, the organisms are readily
destroyed by ordinary germicides, and by the gastric juice. The spores,
on the other hand, have a high degree of resistance. Not only do they
remain viable in the dry state for long periods, even up to a year, but
they survive boiling for five minutes, and must be subjected to dry heat
at 140° C. for several hours before they are destroyed.
[Illustration: FIG. 27.--Bacillus of Anthrax in section of skin, from a
case of malignant pustule; shows vesicle containing bacilli. × 400 diam.
Gram's stain.]
_Clinical Varieties of Anthrax._--In man, anthrax may manifest itself in
one of three clinical forms.
It may be transmitted by means of spores or bacilli directly from a
diseased animal to those who, by their occupation or otherwise, are
brought into contact with it--for example, shepherds, butchers,
veterinary surgeons, or hide-porters. Infection may occur on the face by
the use of a shaving-brush contaminated by spores. The path of infection
is usually through an abrasion of the skin, and the primary
manifestations are local, constituting what is known as _the malignant
pustule_.
In other cases the disease is contracted through the inhalation of the
dried spores into the respiratory passages. This occurs oftenest in
those who work amongst wool, fur, and rags, and a form of acute
pneumonia of great virulence ensues. This affection is known as
_wool-sorter's disease_, and is almost universally fatal.
There is reason to believe that infection may also take place by means
of spores ingested into the alimentary canal in meat or milk derived
from diseased animals, or in infected water.
#Clinical Features of Malignant Pustule.#--We shall here confine
ourselves to the consideration of the local lesion as it occurs in the
skin--_the malignant pustule_.
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