Volume 1
A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr.
- Date:
- 1885-1886
Licence: Public Domain Mark
Credit: A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr. Source: Wellcome Collection.
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![spreading mflamination, as well as a suggestion of the frequent virulence of its cause. In general, the sei'ous inflammations are to be regarded as less severe tliau other varieties, or as representing an early stage of what later may be otherwise characterized by a change in the nature of the products. The purulent variety of inflammation is present when the exudation is abundantly cellular. As has already been stated, such cells are, for the most part, white blood-corpuscles. The purulent exudation, like tlie serous variety, niay appear either on surfaces, when the term secretion is a])plied, or within the lymph-spaces of the connective tissue over a con- siderable space, Avhen the pus is said to be infiltrated. When the infil- tration is more circumscribed and tlie walls of the affected lymph-spaces are destroyed, so that adjoining cavities are thrown into larger holes, an abscess is present, from whose wall pus is constantly derived, while the inflammation is progressive. The attention of the surgeon, in particular, has been directed to the isolation of the immediate cause of suppurative inflammation, and the modern, antiseptic, treatment of wounds is essentially based upon the view of the infectious origin of pus. The frequent presence of microbia in purulent exudation where no precautious are taken to exclude their admission, and their frequent absence or presence in minute quantities where such jirecautions are taken, have suggested that through their influence an inflammatory exudation is likely, if not actually compelled, to become purulent. Whether the microbia or their products are the cause of most suppura- tive inflammations may be regarded as an open question. It is generally admitted, however, that, as a rule, an inflammation becomes purulent in consequence of the presence of an infective agent; in other Avords, that most pus is of an infectious origin and possesses infectious attributes. The labors of Lister in insisting upon the exclusion of all possible putre- factive agencies in the treatment of wounds have met with universal approval, and the basis of his treatment remains fixed, although different methods have been devised for its enforcement. His researches, and those stimulated by liis work, have resulted in the establishment of prin- ciples which affect the whole field of theoretical as well as practical medicine. Although most pus may be considered as due to the action of a virus introduced from without, and capable of indefinite progressive increase within the body, all pus is not to be regarded as of infectious origin. There are pyrogenetic agencies, like petroleum, turpentine, and croton oil, which, introduced into the body, produce suppurative inflammation without the association of microbia. A bland pus is usually in a state of beginning putrescence, so that it is only relatively bland, and acquires extreme virulence when long exjiosed to ]5utrefactive agencies. It is possible that those agencies producing an ichorous pus are the same or different from those present in bland pus. The ichorous exudation contains less corpuscles than bland pus, is more fluid, less opaque, strongly alkaline, of a greenish color, and of offensive odor. In hemorrhagic inflammation tlie exudation contains large numbers of retl blood-coi'puscles. The occurrence of this form is sometimes associated](https://iiif.wellcomecollection.org/image/b20415023_001_0032.jp2/full/800%2C/0/default.jpg)
