A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman.
- William Leishman
- Date:
- 1876
Licence: Public Domain Mark
Credit: A system of midwifery : including the diseases of pregnancy and the puerperal state / by William Leishman. Source: Wellcome Collection.
826/882 page 796
![phlebitis. The circulating medium is poisoned with pus, the result of which may be immediate septic coagulation; or, the poison being ' carried, by detached portions of the thrombus or otherwise, to distant localities, it there produces the secondary phenomena which are dis- 1 closed after death. In a large proportion of these cases, swellings are I observed in the neighbourhood of the joints, which, on being freely 1 incised, give exit to pus. In the worst cases, pus is found within the joint itself, and the ligaments and cartilaginous surfaces afford proof of a rapidly-destructive inflammation. If the eye has been affected, evi- I dence will there be found of inflammation, of equal violence, although | limited in extent. Abscess may also be found in the muscles or cellular ] tissue of the limbs ; and, in other cases, what has been supposed to be an abscess, has turned out on examination, to be an effusion of sero- sanguineous fluid. The brain is rarely affected ; but, within the cavity j of the chest, clear evidence has often been observed of that metastasis of inflammation, to which allusion has already been made, sometimes within the lungs,—which have been found condensed, of a dull red colour, and infiltrated with purulent matter,—while, at other times, the violence of the disease seems to have expended itself mainly on the pleura. The heart is often enlarged and softened; and, within the pericardium, lymph and serum may, with the usual alterations in the membrane itself, afford conclusive proof that inflammation has been present here also. The various portions of the intestinal canal, from the stomach to the rectum, have, in exceptional instances, been found to have been severely affected, usually by a simple extension of tin- inflammatory process from the contiguous position of the peritoneum. Ulceration and perforation of the stomach have been noted in some of those cases. The spleen and liver have also been found to be exten- sively disorganized, and their tissues the seat of single or multiple abscesses. In the greater number of the cases which were examined by Dr. Hulme, he found the omentum inflamed, and frequently black and gangrenous. In no small proportion of fatal cases, the kidnej s have been found to present evidence of similar disorganization, obviously the result of violent inflammation : generally speaking, one kidney only \ is affected. In the malignant variety of the fever, the following indications, in addition to those.which have been already detailed, are mentioned by Dr. Copeland, in his Dictionary of Practical Medicine. In several cases, in which blood-letting had been practised, he observed, that on every occasion I was struck by the peculiar faint odour, and very dark hue of the blood; by the very soft state of the clot when the blood did separate into crassamentum and serum ; by the appearance which occa-](https://iiif.wellcomecollection.org/image/b20388792_0826.jp2/full/800%2C/0/default.jpg)
