The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
B. _Encapsulation._--This occurs only when pus has been present for
some time and when the virulence of the pyogenic organisms is not
intense. We may get encapsulation of pus in any part of the body, the
most typical illustration naturally being within the bones. Around
the purulent focus, as around any other irritating foreign body, the
capsule is formed by condensation of surrounding tissue. This is the
way in which most cold abscesses with their limiting membranes are
produced, those produced by tubercle bacilli having slight irritating
properties. Inasmuch, then, as the biological activity in such a focus
is small, there is time for such encapsulation; while by the membrane
thus formed, or the sanitary cordon, already referred to, protection
is afforded to the surrounding tissues. In such a collection fresh
infection may incite acute disturbances again, and many abscesses
which thus lie latent for a considerable length of time are fanned, as
it were, into a conflagration, when a new and acute inflammation is
produced.
C. _Of the various metamorphoses and chemical changes_ that occur in
that which was originally pus, the caseous and the calcific are the
most common. These also are connected largely with the tuberculous
process, although calcareous particles are found in the pus of
actinomycosis. Under their respective heads these degenerations will be
more particularly described.
Certain names have been given to collections of pus in different
localities or under peculiar circumstances. A collection of pus in
the anterior chamber of the eye is known as _hypopyon_; when in any
preëxisting cavity, it is known as _empyema_ of that cavity, the
_distinction between empyema and abscess_ being that “abscess” means a
circumscribed collection where previously there was no cavity, while
“empyema” implies a normal cavity, without respect to size or location,
filled with this abnormal fluid. The term _empyema_, when not used
in connection with some particular cavity, is understood to refer
to a collection of pus in the pleural cavity. Other names also are
used which are particulate and distinctive; in these the prefix _pyo_
is used while the suffix indicates the part involved; thus we have
_pyothorax_, _pyopericardium_, _pyarthrosis_, etc.
SINUS AND FISTULA.
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