On the origin of inflammation of the veins: and of the causes, consequences, and treatment of purulent depositsLee, Henry, M.D.
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On the origin of inflammation of the veins: and of the causes, consequences, and treatment of purulent deposits
Lee, Henry, M.D.
Blood; Veins -- Diseases
[30] In deducing general conclusions from experiments upon animals, it
must be borne in mind, that in them suppuration is induced with great
difficulty. Many of the appearances produced by the injection of putrid
fluids (as in Experiment XIV) would, in man, probably have terminated
in suppuration. Dr. Sédillot has nevertheless established the fact,
that, generally speaking, a different class of post-mortem appearances
may be expected from the introduction of decomposed serum, to those
produced from fluids containing solid particles.
Another class of cases, in which there would be difficulty in
admitting the doctrine of the introduction of pus in substance into
the circulation, presents itself, where, in the primary affections (as
in Case VI), no evidence can be obtained of the original lesion having
suppurated. The fluids effused in such cases may be serum, lymph, or
blood, mixed in different proportions; and yet the constitutional
symptoms will be exactly similar to those which follow the formation
of pus in other instances. There may exist, both in the primary and
in the secondary affection, every intermediate gradation between the
healthy secretion of a part, and the formation of pure pus, or pus
mixed with blood or lymph, without any of the essential characters of
the disease being absent. An inflamed bursa, or a punctured wound,
without the formation of pus, (Cases IV and V), may give rise to
symptoms as severe, and consequences as fatal, as any that arise
from the direct introduction of pus into the system. The secondary
affections, in such cases, may run their course and prove as speedily
fatal, as where well-formed purulent deposits have taken place. The
most severe constitutional symptoms will sometimes be followed by the
effusion of bloody fluid only, in one of the serous cavities (Case
XXX). It would be unphilosophical, even were it practicable, to refer
such cases to a different disease, merely because the accidental
circumstance of the formation of pus is wanting. The origin of the
affection in such instances may be as well-marked, the poison can often
be traced as distinctly into the system, and the secondary disease may
be as clearly connected with the primary, as in any case where pus
has been originally formed. In some cases again, the constitutional
symptoms which accompany, or are followed by, effusions into distant
parts of the body, begin before sufficient time has elapsed to allow
the supposition that pus can have been fully formed at the original
seat of injury. Such instances occasionally, although rarely, present
themselves in extensive burns and scalds, occurring in enfeebled
habits, and after amputation of the limbs in scrofulous children.
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