The principles and practice of modern surgery / by Robert Druitt.

  • Robert Druitt
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of modern surgery / by Robert Druitt. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    73/616
    mistake for mucus. Vogel, Am. ed. p. 144. — Ed.] Muco-purulent matter is pus, only mixed, perhaps, with epithelium, or modified chemi- cally by various local conditions;—the contact of urine, for instance. A very viscid pus, like mucus, is occasionally found in chronic ab- scesses, containing a large quantity of hydrochlorate of ammonia,—a salt which abounds in unhealthy pus.* 5. Concrete or Lardaceous Pus may either consist of common pus, thickened by the absorption of its watery parts, in consequence of having remained for a long time in a chronic abscess, or bony cavityf — as the antrum and nasal sinuses: — or it may originally be secreted in a thick condition; and in this latter case differs little or nothing from the meli- cerous and atheromatous matter found in wens or other encysted tumours. 6. Putrid Pus has a foetid smell, and alkaline reaction, in consequence of the presence of hydrosulphate of ammonia: which is formed by the de- composition of albumen, when pus is exposed long enough to air and heat. 7. Specific Pus, capable of producing the venereal disease or the small- pox, may not differ in its sensible qualities from the healthiest, but must include some matter in a peculiar state of decomposition, which state is capable of being imparted to other living matter. 8. The pus from spreading ulcers and cancers is thin and serous, con- taining blood-globules, and shreds and debris of the ulcerating tissue. It is said to be ichorous, when thin and acrid; sanious, when thin and bloody ; and grumous, when mingled with dark half-curdled blood. Production of Pus. — We may suppose that pus (according to the views detailed in pp. 53, 63) is liquor sanguinis, whose fibrine has assumed a peculiar low form of organization.J Ramollissement.—This is a peculiar effect of inflammation which is observed in greatest perfection in the brain and spinal cord, portions of which become soft, pulpy, and at last diffluent, like thick cream. It has been shown conclusively by Dr. Hughes Bennett, of Edinburgh, that this process is a mere variation from the ordinary course of suppuration. The affected tissue is first infiltrated with fibrine, which coagulates in the form of granules, which may be seen coating the vessels, and filling up all the space between the ultimate tissue of the organ. Thus the organ affected is rendered perfectly dense or hepatized. The granules next form themselves into nucleated cells (exudation corpuscles), which after a time break up, and are disintegrated, together with the tissue which they infiltrate ; and on examining the softened mass with 'the microscope, it is seen to consist of a mass of granules, either diffused or amalgamated in masses, or con- tained in nucleated cells, and mixed with the debris of the softened tissue. § * Pearson, Phil. Trans. 1810. Mucus gives out more ammonia, when treated by lime or potass, than pus does. -f Mayo, Pathology, p. 159. $ The second Edition of this Work contained a tolerably copious account of the pre- vious theories of Home, Gendrin, &c, on this subject; especially of Gendrin's theory that pus might be formed of softened and disintegrated fibrine, and that pus globules are enlarged and decolorized blood globules. § See Microscopal Journal for Jan. 1843, and Bennett on Softening of the Brain, Ed Med. and Surg. Journ., Dec. 1842. Fig. 4 represents the granules mixed with broken nerve-tubes; from a case of softening of the brain.
    digitised image 1
    digitised image 2
    digitised image 3