On phlebitis of the great venous trunks of the neck subsequent to labour / by Alfred H. M'Clintock.

  • McClintock, Alfred H. (Alfred Henry), 1821-1881.
Date:
[1856]
Catalogue details

Licence: Public Domain Mark

Credit: On phlebitis of the great venous trunks of the neck subsequent to labour / by Alfred H. M'Clintock. Source: Wellcome Collection.

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    5 o’clock in the evening and lasting till 5 the next morn¬ ing. The right,tibia is seen to be considerably swollen, the swelling most prominent about its centre, extending to the tubercle above, and to within a hand’s-breadth of the ankle below. The swelling is hard, except at its centre, where it is soft, fluctuating, and tender. The integuments about this situation are of a yellowish red colour, and oedematous. Be¬ sides this soft and evidently suppurated swelling, the remaining tumefaction of the tibia can be felt to depend on a general fusiform enlargement of the whole substance of the bone, which is three times the size of the other tibia. Skin hot; sweats at night; pulse 92; headach. Fifteen years ago he was seized with pain in the leg and ankle-joint; the leg then swelled, became red and painful, and continued so for eight weeks. It was lanced near the ankle- joint, and a red fluid let out, which gave, ease; but it subse¬ quently broke out in several places along the shin, where there are at present puckered cicatrices. When first they broke open, they discharged red fluid, afterwards yellow matter, but never any pieces of bone. Two days after admission, I made an opening down through the periosteum to the bone, which was soft on the surface, so that the point of the knife stuck readily into it. Pus, mixed with blood, was discharged. Three days after this, great ease having followed the inci¬ sion, and all fever subsided, he was ordered three grains of blue-pill thrice daily, which was continued for three weeks, when he was discharged, well; the bone considerably reduced in size, and a small, granulating spot at the seat of the incision. Secondly, diffuse suppuration in bone is a most formidable affection: the bone itself is often destroyed, the periosteum stripped from the surface of the bone, thickened, its inner sur¬ face of a deep red from the intense inflammation, and profuse suppuration between it and the bone; the larger cancellse and medullary canal of the bone full of pus; there are great pain and swelling of the limb, which is usually oedematous, of a pale pink colour, exquisitely tender. Fluctuation of matter soon becomes evident, and requires free incisions. The matter makes its way from the interior of the bone, through small openings which are formed by the rapid absorption of the bony structure, just as we observe in abscess at the root of a tooth, the matter working its way out by a small hole in the alveolar process at the point of the socket, forming the common gumboil. At other times the matter unhappily makes an entrance into a joint, which then becomes intensely inflamed,
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