The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
=Treatment.=--This should consist of extensive incision to permit
escape of fluids and gases and relieve tension; of such antiseptic
applications as can be made available; of immersion of the affected
part in a hot antiseptic bath; and of such vigorous stimulation by the
most powerful measures--strychnine, alcohol, etc.--in order to support
the patient through the period of profound depression characteristic of
the disease.
[Illustration: PLATE V
Actinomycosis. Ray Fungus in Man. (Gaylord.)]
ACTINOMYCOSIS.
This also is a _subacute_ but always _destructive infection by a
specific microörganism, though not a bacterium_. Known always as
_actinomycosis_ in man, the disease, which is most common in cattle,
is called _lumpy jaw_ or _swelled head_, and years ago was usually
regarded as cancer or as a malignant affection.
Many museum specimens labelled as cancer of the tongue, jaw, etc.,
have been shown to be instances of actinomycosis of these parts. It
is occasionally met with in man, so that there are at least four
hundred cases on record in this country and in Europe. The organism
was recognized a half-century ago by Langenbeck and Lebert, but was
not scientifically described until many years later. The names of
Bollinger, Israel, and Ponfick will always be connected with these
researches.
The organism belongs among the _ray fungi_, is known as the
_actinomycis_, and occupies an uncertain place in classification.
It is large enough, when entire, to be perceived by the naked eye,
has ordinarily a yellowish tint, a tallowy consistence, and may
be seen under the microscope to consist of a cluster of branching
prolongations, club-shaped at the end, radiating from a common centre.
They give it a sunflower appearance. It is stained with difficulty,
the best stain being a combination of picrocarmine and an aniline dye.
In tissue sections the Gram stain is the best. It is cultivated with
difficulty, but can be grown upon solid media and may be inoculated.
(See Plate V.)
As met with in tissue or in pus these fungi constitute small
granulations, giving usually a gritty sensation to the finger, which
is due to the presence of calcium salts. The recognition of this
calcareous material is of importance, since it may enable a diagnosis
to be made offhand, in a case which otherwise might puzzle one.
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