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Show OF THE ISOAS ABSCESS. CHAPTER III, OF THE PSOAS ABSCESS. Heston- Emmi; ‘ most esIn the treatment of sinuses and abscesses, the E collecsential point to be known is, what has produced the 11' we for ved- remo be tion of matter, and whether the cause shall we are to cut up fistula: during their tendency to form, lves. find that only deeper and larger passages open themse by der consi to first ought If we are to open an abscess, we the of n what means we are to produce a change in the actio It part. f i l. E E hke The matter of an abscess is not collected, but, ? t. nge; the fluids of the cavities of the body, it is suffering a‘cha that time the absorption of the pus is performed at the same pus is thrown out by the vessels; and the increase or dnnlve nution of the matter of the abscess depends on the relati e observ to action of the arteries or absorbents. We have i is ac~ what further change, besides evacuation of the matter, é ‘ complished by opening an abscess. seem W111. s absces Experience teaches us that a scrophulous nt: to point, being soft and prominent, and having fluidlev1de thlb ly in it; and yet that when the lancet is thrust into 0f wallsthe and s, tumour, only a pale watery fluid escape 9 h‘!‘ E ss, like the tumour acquire an inelastic, but irregular, firmne meted. l [~W‘?'CP dwmflfmnqwn .. r-"~: a w- a cake: and the progress of the action, or at least the softening of the tumour towards the surface is not promoted but a checked. The scrophulous action is here, I suppose, of slow and sluggish nature, and the phlegmonous action, the contrary tenconsequence of the wound, has somewhat of a is not prodency, so that the original progress of the disease or THE rsoiis ABSCESS. 8:} Again, in the scrophulous action about joints which has produced abscess, by cutting into this abscess the slow na« ture of the disease is changed; the matter, though evacuated, collects again, no longer bland or mild, but putrid and acrid, and an irrecoverable caries may be the consequence*. It is of little importance whether the change in this particular instance is to be attributed to the air getting access to the secreted matter, and producing an alteration upon it, making it acrid and stimulating; or whether the incision changes the nature of the action in the surface of the cavity, so as to produce bad and foetid matter. But it is particularly of consequence to observe this contrast, that by stimulating the surface and making counter irritation on such a scrophulous joint, the original action might have been changed, and the limb and patient saved; while under this surgical treatment the disease has rapidly advanced. Where an abscess or extensive fistula forms, in consequence of a wound, it may be permitted to rouse the activity of the surface by an injection or seton, for perhaps there is nothing peculiar in the action ; there is only a weakness and inactivity; and by habit the secretion continues-But even here it will in general be better to raise the life and activity of the whole limb, by admitting freer motion, by warm stimulant fomentation and rubefacients.--For though these communications and abscesses have formed after an injury, it by no means follows that they are merely the consequence of that injury; they have often a scrophulous action; and the injections or seton raise a violent inflammation, and ge' neral tension of the limb, which instead of promoting the adhesion of the cavities form others in succession. All abscesses or fistula: connected with ducts or natural passages form a class by themselves, which ought not to en‘ Experience teaches us that it is useless to open scrophuious and venerc. al abscesses ; but further, we find the practice bad as complicat ing the case. and dangerous as sometimes productive ofthe phagedaznic ulcer. Read the SCCL‘OH on abscess in Ford's Obserzstions on the hip disease, which is i n-ry Valuable |
