The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Pus may form superficially, when it is called subcutaneous suppuration,
in which case there is a minimum of pain, because tension is not
great and the distance to the surface is short. Collections which
form beneath the fasciæ, especially the deeper fasciæ of the limbs
and trunk, give rise to much more extensive disturbance, both locally
and generally, and frequently do not point for many days; or, instead
of pointing, burrow deeply and find their outlet at some undesirable
point. These are known as _subfascial_ collections. _Subperiosteal_
abscesses give rise to still more pain, because of the unyielding
character of their limiting structures, and the symptoms caused by them
are acute and distressing.
An illustration of the pain which may follow deep suppuration may also
be seen in the ordinary panaritium, or bone felon, where the path of
infection is from without, but the destructive lesion is confined
within absolutely unyielding tissues, at least at first. Along certain
tissues infection spreads with rapidity. This is particularly true of
the delicate areolar tissue seen between tendons and tendon sheaths,
and the infectious process may follow this tissue wherever it shall
lead, even along complex courses.
The question often arises, _Can pus be resorbed?_ There is no question
but that small amounts of pus are disposed of by phagocytic activity,
and the disappearance of purulent infiltration, under the influence of
favoring remedies, or even when let alone, is not infrequently noted.
True pus resorption is a question of phagocytic possibilities, and
can occur only in very limited degree, as a result upon which it is
not safe to count, and which is capable of encouragement only up to a
certain point.
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