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
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.
![cular infection if organisms happen to be circulating in the l^lood at the time. As we have seen, micro-organisms may from time to time be found in the cir- culating blood, particularly in individuals of feeble constitutions. The ana- tomical nature of the part will therefore fjivor suppuration in certain localities. A most familiar example is the lymphatic gland tissue. There the organisms which have invaded the tissues through a wound, and have found their way into the lympliatic vessels, are arrested, and a glandular abscess results. The condition of tlie blood is also a predisposing cause, as tlie tendency to carbun- cular inlianniKition in dia])etes shows. The material which forms as the result of suppurative inflammation is pus. Pus is a yellowish-white fluid of the consistency of milk or cream, of an alkaline reaction, and commonly nearly odorless. It has a specific gravity of about 1030, and when allowed to stand it separates into a clear fluid known as pus serum, and a sediment which averages from 10 per cent, to 20 per cent, of the whole amount. The liquor puris, or pus serum, is a pale greenish-yellow fluid which does not coagulate spontaneously, and contains an albuminous substance known as peptone. The salts which it contains are present in about the same proportion as in the blood. The sediment consists of pus-corpuscles, the pyogenic cocci and the other forms of micro-organisms that may be present, and fragments of broken-down tissue. Most of the pus-corpuscles are the altered leucocytes which have escaped from the blood-vessels with the exudation; others are derived from the prolif- erated fixed connective-tissue cells. When first taken from a fresh abscess many of them are found to possess amoeboid movements. They are a little larger than the white blood-corpuscles. Their protoplasm is somewhat gran- ular, and when acetic acid is added to them they are found to contain several nuclei. This polynuclear condition was supposed to be evidence of an ability of the pus-corpuscles to proliferate, but it is now recognized as a sign of degen- eration. They also occasionally contain drops of fat; others are full of large granules, which, Avhen they break up, liberate a granular detritus Avhich may be seen suspended in the fluid. The color of pus is occasionally blue. This is due to the presence of the bacillus pyocyaneus, ordinarily considered a harmless organism, but the presence of which indicates slowness of repair. Orange-colored pus is caused by the presence of hematoidin crystals, and is found in some forms of inflammation. It is probably due to the fact that many red corpuscles in the exudation have been broken up by the septic process, The peculiar foul odor of pus which comes from the neighborhood of the vagina or rectum is due to the presence of the bacillus pyogenes foetidus. The thick creamy, odorless pus which flows from an acute abscess was formerly known as healthy or laudable pus. It contains comparatively few bacteria. Pus may occasionally undergo decomposition; in this case the micro-organisms of putrefaction also are found in it, and the pus-corpuscles are broken down and much diminished in number. This is known as ichorous pus, and Avhen mixed with blood which is seen flowing from a rapidly-spreading abscess is called sanious pus. These unhealthy forms of pus are very acrid and give an acid reaction. A microscopical examination of the connective tissue in suppurative inflam- mation shows that in the early stages of the process the stellate cells of the tissue lose their prolongations, become rounded, and undergo karyokinesis, and](https://iiif.wellcomecollection.org/image/b21217014_0075.jp2/full/800%2C/0/default.jpg)
