The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Serous transudates from free surfaces are sometimes spoken of as serous
_catarrhs_; when into cavities, as _dropsies_; when into tissues,
as _edema_; when occurring beneath the epidermis they form _serous
vesicles_ or _blebs_ or _bullæ_.
_Fibrinous_ exudation refers to the fluid which coagulates soon after
its exit from the vessels within those spaces into which it has
oozed. When flocculi of coagula float in serous fluid it is known as
a _serofibrinous_ exudate. Pure fibrinous exudate occurs rarely, save
in and upon mucous membranes. The extent to which exposure to the air
is responsible for the firm coagulation of the fibrin previously held
in solution is uncertain. The most potent factors in producing such
coagulation are bacteria, but it is not yet disproved that coagulation
may occur without their aid. When such coagulation occurs upon the
surface of a mucous membrane it has been spoken of as _croupous_. When
the epithelial covering as well as the basement membrane, and often
the submucous tissues, are involved, so that the membrane cannot be
stripped off without tearing across minute bloodvessels, the exudate
has been known as _diphtheritic_. These terms may possibly be still
retained in an adjective sense as implying the exact location of a
surface exudate, but are scarcely to be used in any other significance.
The following table illustrates significant differences whose full
importance cannot be impressed before a study of inflammation has been
carefully entered upon:
_Hyperemic Transudates._ _Inflammatory Exudates._
Poor in albumin. Rich in albumin.
Rarely coagulate in the tissues. Usually coagulate in the tissues.
Contain few cells. Contain numerous cells.
Low specific gravity. High specific gravity.
Contain no peptone. Contain peptone (product of cell
disintegration).
TREATMENT OF CONGESTION AND HYPEREMIA.
These disturbances are to be combated, first of all, by insisting upon
_physiological rest_. This, perhaps, is the most important measure of
all. The profession is indebted to Hilton for the decided advance which
he made in the treatment of congestive and inflammatory affections
by insisting upon this principle in his celebrated work on _Rest and
Pain_, which every young practitioner should read. Aside from this
first and underlying principle, the treatment must, in some measure
at least, be based upon the time at which we are called upon to treat
the case. If seen at once, before exudation has been excessive or the
other disturbances marked, we may carry out a certain line of treatment
for the purpose of limiting all these unpleasant features. On the other
hand, if seen late, when exudation has been copious and when pain and
other disturbances are due to its presence, a distinctly different
course will be adopted.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account