Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Cellulitis.+ In cellulitis, redness of the skin is not very pronounced
and is late in appearing, following swelling, and not preceding it. It
is essentially the same condition as a mild form of erysipelas. Its
spread is heralded by red lines of lymphangitis, ascending from a
wound (infected), swelling of glands, and fever.
In slight cases, the lymphatics may dispose of the poison, and
suppuration fails to occur. In severe cases septicema arises.
Cellulitis is usually a result of infection not only with
streptococci, but also with other pyogenic cocci.
+Treatment.+ Incise and curet the wound and apply one of the wet
dressings. (See chapter on same).
+Actinomycosis.+ This is an infectious disease characterized by chronic
inflammation, and is due to the presence in the tissues of the
actinomyces, or ray fungus. At the point of inoculation arises an
infective granuloma, around which inflammation of connective tissues
occurs; suppuration eventually taking place. Inoculation in the mouth
is by way of an abrasion of mucous membrane or through a carious
tooth. The fungi may pass into the bones and joints, causing
inflammation of the parts. The bones in actinomycosis enlarge and
become painful; the parts adjacent are infiltrated and soften; pus
forms and reaches the surface through fistulae and the skin is often
involved secondarily. In actinomycosis the adjacent lymphatic glands
are not involved.
+Treatment.+ Free incision, if possible, otherwise incision, cauterizing
with pure carbolic acid, and packing with iodoform gauze. Internally,
large doses of iodide of potassium should be given, as this drug alone
has cured many cases.
+Trench Foot.+ This results from exposure to wet and cold in the
trenches, and soldiers who were compelled to have their feet immersed
in water for any length of time and were then exposed to cold, are
afflicted with this condition. The symptoms are similar to frost bite
and the prevention of frigorism (Trench Foot) is as follows: adequate
feeding; perfect circulation; moderate exercise; good general health;
and warm clothing, which all tend to give the body its maximum power
of resistance to cold.
It is obvious that anything that tends to impair the circulation and
the nutrition of the tissues is favorable to the occurrence of
frigorism. Tightness of the clothing of the extremities, such as tight
boots, leggins, etc., is particularly detrimental. Heavy clothing and
other equipment, by increasing fatigue, also has a predisposing
influence.
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