The principles and practice of medicine / by John Elliotson ; edited by Nathaniel Rogers and Alexander Cooper Lee.

Date:
1846
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Licence: Public Domain Mark

Credit: The principles and practice of medicine / by John Elliotson ; edited by Nathaniel Rogers and Alexander Cooper Lee. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    INFLAMMATION. appropriate membrane.” Every physiological fact with which we are ac- quainted, favouring the opinion that pus is secreted from the blood in the 1 form of a clear fluid, and that its globules are afterwards formed ; it occurred to Drs. Babingtou and Bird, to institute experiments with a view to extend the analogy between them ; and the results to which they were conducted, constitute most important additions to the science of organic chemistry. I They have demonstrated, and their conclusions are supported by the more , elaborate researches of Mandl, that pus differs from mucus, only in having in solution a large quantity of albumen, coagulable by heat, acids, and the ordinary agents; in containing iron; and in the incinerated ashes of pus affording a much smaller quantity of saline matter than those of mucus. And they have rendered it extremely probable that the animal matter of mucus is albumen, in a diminished quantity and modified form.—T. Williams.'] As to all these distinctions, however, the fact that pus and mucus are convertible into each other, is established by modern organic analysis. Mucus may be diseased, so as to be something like pus,—puriform; and they will run into each other by insensible degrees. In disease of the lungs, the distinction between pus and mucus has been thought most im- portant, as tending to shew whether ulceration exists; but here the two secretions are continually mixed together. When there is an abscess of the lungs, or a number of abscesses, and matter is discharged from them, a quantity of mucus is at the same time secreted from the bronchial tubes; so that the pus and the mucus are expectorated together; and in proportion as the former surpasses the latter in quantity, or the latter exceeds the quantity of the former, the characters of the one or the other are presented. If the quantity of mucus be very considerable, the pus may be borne up by it in water,—not allowed to sink. Besides this, there may be an abscess in the lungs; and there may also be an excavation secreting, not pus, but mucus. The lining membrane of the cavity in the lungs—at least, if fresh ulceration have not taken place—may secrete mere mucus. Again : every mucous membrane which is inflamed, may produce absolute pus; so that pus may be discharged from the lungs, when there is no ulceration at all; while, on the other hand, there may be ulceration of the lungs; but the lining membrane of the abscess may have become of such a mucous cha- racter, as to secrete real mucus. Analysis of Pus.—With regard to the constitution of pus, Schwilgue j (who is one of the last that has analyzed it) says that it consists of albu- men, extractive matter, fatty matter, soda, muriate of soda, phosphate of I lime, and some other salts. When pus is scrofulous, it is said to have more j soda and muriate of soda, than healthy pus. Pus was once imagined to consist of the dissolved solids. Seeing that a cavity existed, it was ima- gined that the solids were melted down, and turned into pus. But fre- quently pus may appear when there is no ulceration at all; nor is the formation of pus in proportion to the loss of the solids. From a small abscess, there may be an immense secretion of pus, if by chance the abscess ; do not heal; and yet it does not extend. The pus is a new excretion. Whether globules are formed in it,—whether it be perfect immediately or not,—is of no consideration. The fluid from which pus is produced is a secretion. It appears to possess solvent properties; for John Hunter found dead flesh dissolve very readily in pus. He put an equal quantity of dead flesh into pus, into jelly, and into water; and he found the portion put into pus dissolve very readily, while the portions put into jelly and water did
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