An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White.

  • William Williams Keen
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    ultimate deatli by exhaustion, sepsis, or pyemia. When the disease is early recognized and the afteeted part is susceptible of thoroiiifb extii pjition, a ciii-e may be obtained. Treatment.—Absolute extirpation of all infected tissue should be done whenever practicable, the incisions bcini; ciirried through sound tissue at some distance from the visibly infected ])art. If this is impracticable, the sup- purating cavities and sinuses sliould be laid o])en freely and the surrounding infecteil tissue should be excised as far as j)Ossible; thorough curetting of the remaining diseased tissue should be done, followed by numerous injections of a strong carbolic solution (1:20) into the substance of the tumor that may still remain. Into any sinuses that have not been fully laid open tampons saturated with solution of chloride of zinc (1:8) should be packed, and the whole diseased surface that has been exposed should be dressed with similar tampons. The wound should be kept open and the curetting and cauteriza- tion repeated as often as any suspicious points show themselves. Recently- published experiences of veterinarians indicate that iodide of potassium given internally in full doses, pushed to the point of iodism, has a specific curative effect upon actinomycosis in a large proportion of cases in cattle. It should therefore be given a trial in cases in human beings. CHAPTER XVII. SYPHILIS. Syphilis^ is an infectious, contagious, and inoculable disease, transmissible also by heredity. It first manifests itself by an indurated or infecting chancre, followed by general lymphatic enlargement, afterward by eruptions of the skin, usually symmetrical and at first superficial, and by allied conditions of the mucous membranes, later by chronic inflammation and infiltration of the cellulo-vascu- lar tissue and bones and periosteum, and finally by special productions in the form of small swellings, which may invade any tissue or organ of the body, but chiefly involve the connective tissue, and are known as gummata. During all the acute symptoms, and for a period extending over several years, the patient has acquired an immunity against fresh infection. The dis- ease is probably caused by the entrance of a specific microbe into the system, and although the final and conclusive evidence, consisting of the isolation, cul- ture, propagation, and re-inoculation of the micro-organism, is still lacking, the clinical facts alone are sufficient, in the light of our present knowledge of the microbic diseases, to place syphilis in that class. Considered in this man- ner, as has been done by Finger, the various symptoms and stages of syphilis are to be explained as follows: The general symptoms in the primary stage of syphilis—the languor, fever, malaise, pain, etc.—are due to intoxication by the ptomaines produced by the virus, as these symptoms are too ephemeral and changing to be ascribed to localizations of the virus. In the secondary stage the vai'ious eruptions on the skin and mucous membranes are caused by local deposits of the virus. Their virulence proves this; but a great many of the so-called secondary symptoms ' The histology and patholog}' of syphilis will doubtless before long have to be rewritten from the bacteriological standpoint. At present the observations of Cornil are the most accu- rate and reliable in our possession, and have been closely followed in this work. (See Comi] On Syphilis, American edition.)