The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
It is seldom that a superficial collection of pus can be mistaken for
anything else. In small and superficial abscesses (boils, furuncles)
as pus approaches the superficial layer (epidermis) of the skin it
may be discovered through its thin covering. In deep lesions there is
often a doubt, even on the part of the most experienced. The measure
now usually resorted to for purposes of diagnosis and exact recognition
is the exploring or aspirating needle. The old exploring needle was
one of good size, having a groove along which, after introduction, pus
might pass. Since the almost universal use of the hypodermic syringe, a
small aspirating needle attached to the ordinary syringe is the measure
commonly adopted. Such a needle may be introduced into the brain, into
the liver, or into almost any and every soft tissue without danger, and
if properly manipulated is almost sure to facilitate detection of pus.
Exploration done with either of these means and for this purpose should
always be conducted as an aseptic, even if a minor operation, in order
that no extra infection may be added from without. The skin should be
carefully washed, the needle sterilized, etc.
It is good surgery to resort to the knife either for the above purpose
or in order that by a longer incision or by opening the cavity deep
exploration may be made. Such explorations are of benefit even though
a circumscribed collection of pus is not found, since by relief of
tension and local abstraction of blood they act in a revulsive way and
do much good. Acting upon the same principle the trephine or the bone
chisel may be used for the purpose of opening the cranium and exploring
for pus, or of opening into the medullary canal of the long bones and
hunting there for that which is suspected.
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