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Show 16 CARBL'NLLLE. OF ABSCESS. and inflammation diminish, and the pulse sinks. The symp. the cellular membrane, and it. is attended with a peculiar thiclp toms are sometimes ushered in by rigor, and a flushing of the face. The patient sometimes lies comatose before his death. If there be an extensive wound, a llaccidity of the skin, with dryness and livid colour, precedes. Il'thcre is an ulcer, it be~ comes dry and discoloured. In saying that mortincation sometimes fellows high action, I am proceeding more upon authority than I ought; for l have not seen gangrene the consequence of high inflamn‘iatory action: it should rather be called high irritation, which dis« orders and overcomes the inflannnatory action, and is followed by mortification. There are, however, frequent instances of that swelling and binding of the parts, the consequence of the infiltration into the cellular membrane, and as it were suffocation of the arterial ac- 350w~ mom i 35., rhyé-u- .5: :2‘ ..: l tion, which is followed by gangrene of the limb. This is par ticularly frequent after gun-shot wounds, and occasions us to make deep incisions, to unbridle and give freedom to the. parts. The practical surgeon will have often to trace the gangrene to the improper bandaging, some times merely to the binding of the splints in fracture; often to the close bandaging of lacerat- ening of the skin, and redness. The centre of the disease is fixed : it does not shift, though it spreads until it forms a flat and broad tumour. There is matter formed, but it is con« tained in cells of the membrane, and not as an abscess; nor is it diffused, as in the erysipelas. There is not a pointing of the tumour, as in phlegmonous abscess; but the surface becoming more dark and livid, a number of openings form on the quaggy cells, which discharge the fluid. The carbuncle forms commonly on the trunk, generally on the back, or on the nape of the neck, or over the stomach ; seldom on the head or extremities. In short, it attacks the integuments Where they are naturally much insulated from being over tendinous expansions, or fascia. It has been con- sidered as almost peculiar to the debilitated state of the rich and luxurious. 43:9.041.n. : a 0F ABSCESS. cd wounds, with a hmmorrhagy, which has required the firm compress and bondage. When a swelling and dark-coloured AN abscess is a suppuration where the matter is collected, and where there is at first no outward communication. Its seat is in the cellular membrane. It is a process of the inflammation of the skin is seen betwixt the turns of the roller, phlegmonous action, and whilst the vessels pour out the pus, they should be immediately undone. ,S'lzliarslus is the complete state of mortification, with derangement of structure from the prevalence of other laws than those which characterize the living lfl it}: the inflammation condenses the surrounding soft parts, so that by the pressure of the matter, and the action of thelvessels, and the throwing out of the coagulable lymph, a regular cyst ‘ is in time formed, which contains the matter of the abscess. 3","... ,_._-...A..- «guy ..-,- .=' ~09 " W .. .l‘»"'"~('- ...,...- -" An abscess is formed in these stages. 1. There is increasing 01" CARBUHC L L'. " .....L. n .begins , g ‘ .1 no (.tixvtlllflc _ .. . . . on the surlacc, like a pimple; but 111 its progress it goes deep, and spreads wide, having its base in But ifthe inflammation has made its attack, and is running into gangrcne‘, "'1: should try to secure a full suppnration by t'ouicntation of the limb, Whllb tnv general action ofthe vascular system is mitigated. In gangrene, howeverprodnced, we must support the strength by wine and brandy (takinl‘,~ ‘. are not to raise a linsh on Tilt check, or produce drunkenness, which Will i; .3 lollowed by dClJllli:.'), and by bark and acid, guarding the stomach from SUZM'L mica, and the bowels from flatule nce. redness, heat, tension, and throbbing; the whole system is highly excited; one or more rigors succeed. 2. The irrita- tion and fever subside, and there is relief of pain; and now if the abscess be superficial, there is a redness observable on the surface, it points,- ulceration takes place in the skin; it bursts and discharges, to the more perfect relief of the patient. 3. If the abscess be of great extent, this relief is transient ; in about forty-eight hours. an icherons discharge takes place of vor. 1. o "at Mll\.1€‘tx ,- |