Scientific American Supplement, No. 810, July 11, 1891Various
Science
Scientific American Supplement, No. 810, July 11, 1891
Various
Science -- Periodicals
Having occupied a portion of the time allotted to me in giving a crude
and hurried account of the characteristics of bacteria, let me
conclude my address by discussing the relation of bacteria to the
diseases most frequently met with by the surgeon.
Mechanical irritations produce a very temporary and slight
inflammation, which rapidly subsides, because of the tendency of
nature to restore the parts to health. Severe injuries, therefore,
will soon become healed and cured if no germs enter the wound.
Suppuration of operative and accidental wounds was, until recently,
supposed to be essential. We now know, however, that wounds will not
suppurate if kept perfectly free from one of the dozen forms of
bacteria that are known to give rise to the formation of pus.
The doctrine of present surgical pathology is that suppuration will
not take place if pus-forming bacteria are kept out of the wound,
which will heal by first intention without inflammation and without
inflammatory fever.
In making this statement I am not unaware that there is a certain
amount of fever following various severe wounds within twenty-four
hours, even when no suppuration occurs. This wound fever, however, is
transitory; not high; and entirely different from the prolonged
condition of high temperature formerly observed nearly always after
operations and injuries. The occurrence of this "inflammatory,"
"traumatic," "surgical," or "symptomatic" fever, as it was formerly
called, means that the patient has been subjected to the poisonous
influence of putrefactive germs, the germs of suppuration, or both.
We now know why it is that certain cases of suppuration are not
circumscribed but diffuse, so that the pus dissects up the fascias and
muscles and destroys with great rapidity the cellular tissue. This
form of suppuration is due to a particular form of bacterium called
the pus-causing "chain coccus." Circumscribed abscesses, however, are
due to one or more of the other pus-causing micro-organisms.
How much more intelligent is this explanation than the old one that
diffuse abscesses depended upon some curious characteristic of the
patient. It is a satisfaction to know that the two forms of abscess
differ because they are the result of inoculation with different
germs. It is practically a fact that wherever there is found a diffuse
abscess there will be discovered the streptococcus pyogenes, which is
the name of the chain coccus above mentioned.
So, also, is it easy now to understand the formation of what the old
surgeons called "cold" abscesses, and to account for the difference in
appearance of its puriform secretion from the pus of acute abscesses.
Careful search in the fluid coming from such "cold" abscesses reveals
the presence of the bacillus of tuberculosis, and proves that a "cold"
abscess is not a true abscess, but a lesion of local tuberculosis.
Public-domain text, read in full here on John Shaqi.
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