Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
Embedded bodies may remain in the tissues for an indefinite period
without giving rise to inconvenience. At any time, however, they may
cause trouble, either as a result of infective complications, or by
inducing the formation of a mass of inflammatory tissue around them,
which may simulate a gumma, a tuberculous focus, or a sarcoma. This
latter condition may give rise to difficulties in diagnosis,
particularly if there is no history forthcoming of the entrance of the
foreign body. The ignorance of patients regarding the possible lodgment
in the tissues of a foreign body--even of considerable size--is
remarkable. In such cases the X-rays will reveal the presence of the
foreign body if it is sufficiently opaque to cast a shadow. The heavy,
lead-containing varieties of glass throw very definite shadows little
inferior in sharpness and definition to those of metal; almost all the
ordinary forms of commercial glass also may be shown up by the X-rays.
Foreign bodies encapsulated in the peritoneal cavity are specially
dangerous, as the proximity of the intestine furnishes a constant
possibility of infection.
The question of removal of the foreign body must be decided according to
the conditions present in individual cases; in searching for a foreign
body in the tissues, unless it has been accurately located, a general
anæsthetic is to be preferred.
BURNS AND SCALDS
The distinction between a burn which results from the action of dry heat
on the tissues of the body and a scald which results from the action of
moist heat, has no clinical significance.
In young and debilitated subjects hot poultices may produce injuries of
the nature of burns. In old people with enfeebled circulation mere
exposure to a strong fire may cause severe degrees of burning, the
clothes covering the part being uninjured. This may also occur about the
feet, legs, or knees of persons while intoxicated who have fallen asleep
before the fire.
The damage done to the tissues by strong caustics, such as fuming nitric
acid, sulphuric acid, caustic potash, nitrate of silver, or arsenical
paste, presents pathological and clinical features almost identical with
those resulting from heat. Electricity and the Röntgen rays also produce
lesions of the nature of burns.
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