A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    123/878 (page 99)
    SECONDARY INFLAMMATION AND DEPOSITS. m all directions; there may be evident marks of surrounding inflam- mation; while, again, in some instances, in a large joint, for example, the slightest trace of preceding disease cannot be detected. Often the inflammation, suppuration, and lymphatic effusion may be connected with the medullary sheath of a bone or a large vein; and the doctrine has been held by Cruveilhier and others that these parts are generally more or less involved in such secondary affections. The constitutional symptoms in these cases generally at first denote a higp degree of excitement, but they soon indicate a typhoid condi- tion, and death is the usual result. The symptoms of low fever often come on so insidiously that the practitioner is astonished that he has m a manner overlooked the coming danger until such a state has given the first serious alarm. Many imagine that these symptoms are occasioned by the presence of pus globules in the blood, and that the secondary deposits are the results of the separation of the pus from the circulation. In my remarks on the premonitory symptoms of suppu- ration I have made some allusions to shiverings as indicative of this result. Kigors are of common occurrence in the early stages of the condition at present under consideration, and if with these there be a quick, small pulse, a dry, brown, furred tongue, a sunken, unmeaning ^ It dmgy yeilow Colour’ there is much reason to dread the worst The wound, in such a case, if it be still open, will dlscharge; there may be constipation in the bowels, or » dlarrhma,especiallyln the latter stages of the affection; there may perhaps be difficulty of respiration, pain, and other symptoms ZtZTr °f Set10US^ deran^ernt Within the chest’ or there may be r^PPr^ndrmiSChlef eisewhere‘ In short< the state of the Srmt nf f l iG fr°m tJhat familiar to the physician in the worst forms of typhus fever, and on that account I shall decline on the present occasion entering further on this part of the subject. . ls weI1 known how futile the practice of physic is in such instances, and the same must be admitted for that of surgery De- £ W ghmeam 8 r ^ TeIy be emP'°y«i. Velpeau, Dr. Norris, and selii i,e,tVBtrTr0ba!iedrt le ?ractlce>and 1 ««mot say that I have ever h o wf, .uT fr0m In a Purely i^^ntatory affection of he lungs, which may to all appearance have been induced by an lTeV!1 S°“e dlstant ,ParJ’ or P°ssib‘y by the deligation of some large artery in the neck, the use of the lancet may perhaps be not only justifiable, but of much value; yet should there be^typhoid symptoms present, the practice is more likely to do harm. But the discussion of such matters belongs more properly to the physician; and as a surgeon, then, I have little to say regarding the purely surgical treatment of these secondary inflammations and deposits, ^n such Sarlrf ^ d !!meS uY hfPPy °men shouId the wound begm to deemed8 m£mfvnid ?Ch °CR treatment shoilld be resorted as is delTd mos1t, hkely to encourage this favourable change. In the :Iach °/na coll.ectl°n of fluid forming anywhere within the surgeon’s ■each, a question as to giving it an exit may arise, and, generally, his