Clinical lectures and essays / by Sir James Paget ; edited by Howard Marsh.

  • James Paget
Date:
1875
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Licence: Public Domain Mark

Credit: Clinical lectures and essays / by Sir James Paget ; edited by Howard Marsh. Source: Wellcome Collection.

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    operations, except in so far as they are feeble and may die (though they rarely do) through slow exhaustion, or the gradual development of some internal organic disease. The relief from pain and the removal of irritation com- monly seem more than enough to compensate for the shock and other depressing influences they are at first submitted to. They seem not very lable to pysmia, erysipelas, or other of these sore plagues. All this you may see often enough in our cases of excision of joints; and in these same you may also see, better than in any others, what are the defects of the scrofulous constitution in reference to recovery from operations. The wounds heal very slowly; the cellular tissue is apt to become very the scars are thin, and often ? cedematous and ‘gummy ; break down and ulcerate; the deeper cuttings become sinuous, with tedious discharges of thin pus, and wasting. In a word, the half-healed wounds are apt to become like scrofulous ulcers; and if the patients remain long uncured, their constitutional scrofula is increased by long confinement, and perhaps by hospital-air. Thus, you may sometimes find (but it ought to be in a small minority of cases) that scrofulous patients seem to be, if I may so speak, made more scrofulous by the removal of a diseased limb or joint. And this is, no doubt, the explanation of some of the cases which have led to a belief often entertained, that the removal of scrofulous disease from one part induces its occurrence, or ageravates it, in another. There are, indeed, some cases, especially among the middle-aged and older, in which the two events do seem to stand in direct relations. You may have seen last year a girl in Sitwell, whose forefinger
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