Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    153/864 page 137
    Cause.—Erysipelas depends upon the introduction of an infective poison into the system ; but for this to act it appears to be necessary that the vitality of the body should be lowered, and the tissues in consequence rendered less able to resist the injimous influence of the poison. The causes, therefore, may be divided into the predisposing and the exciting, the predisposing again into those that are general and those that are local. The generalpredisposiruj causes are such as pertain either to [a] the state of nutrition of the body, or (S) its euAaron- ment. (a). Among the conditions that predispose to the disease by inducing an impaired state of the tissues are —1, chi-onic alcoholism ; 2, Bright's disease; 3, dialoetes; 4, gout; 5, malignant disease; 6, insufficient food; 7, want of exercise combined with high living; 8, j^revious attacks of the disease, (h). Among the causes that pertain to the environment of the body are bad hygienic conditions of all kinds, as—1, imperfect ventilation; 2, defective drains ; 3, accumulation of the products of decomposing organic matter; 4, overcrowding; 5, want of cleanliness; 6, a large number of suppirrating wounds in an hospital; and, 7, probably certain not altogether understood atmo- spheric influences. The local predisposinfj cause is the presence of a wound, scratch, or abrasion of the surface, and especially of a lacerated wound, or one in which the dischai'ge is undergoing putrefaction. The exciting cause is the introduction of some infective poison into the system. This poison is probably not the same in each form of the disease. In the cutaneous form it would appear from the observations of Eehleisen, to be a species of micrococcus. It had been known for some time that micrococci existed in the spreading margin of cutaneous erysipelas. Fehleisen cultivated some micro- cocci from this soiu^ce, in some instances thi'ough thirty generations, i.e., for upwards of six months, and their inoculated several ])atients, in all of whom, with the exception of one, who had just recovered from an attack of the disease, erysipelas, after an incubation period of from 15 to GO hours, was set up.* The contagion may bo convoyed by the hands of the surgeon or nui-se, by ius'tru- incnts, sponges, &c., and probably l)y air and water. It is now supposed to enter tlie system in all cases through a * These inoculations were umlcrtakcn for the cure of lupus and malignant tumours, and in two instances apparently with success.
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