Researches on suppuration. Sect. 1. On the frequent presence and on the effects of pus in the blood, in diseases attended by inflammation and suppuration / by George Gulliver.

Date:
[1838]
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Licence: Public Domain Mark

Credit: Researches on suppuration. Sect. 1. On the frequent presence and on the effects of pus in the blood, in diseases attended by inflammation and suppuration / by George Gulliver. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    seen nothing like pus-globules in the softened fibrinous clots of the heart; and the rounded particles which sometimes oc- cur in softened coagula of veins are probably the remains of blood-corpuscles. The conversion of the latter into those of pus is extremely probable, and it is equally probable that this change may take place either in the capillaries or out of them. In the former case, after the stagnation of the blood in these vessels which preceded the suppurative process, as the clot softened and the pus became mature, it would be car- ried into the circulation, and hence its presence in the blood independently of wounds or abscesses. In instances of idiopathic or traumatic phlebitis, the man- ner in which the pus may become mixed with the blood is ob- vious enough. There is a class of cases to which the latter appellation is commonly applied, which are probably not ex- amples of inflamed veins. They seem rather to be of an op- posite nature; for I have seen large veins, which had been di- vided many days before death, containing purulent fluid, al-• though their inner surfaces presented no marks of inflamma- tion ; f-nd the total failure of this process in them would seem to have left open their wounds, so as to favour the entrance of pus into them from the neighbouring parts : and this con- sideration would involve an important point of practice. It might be asked if, on a suppurating surface, the pus-glo- bules, considerably larger than those of blood, escape from the capillaries, how comes it that the latter particles do not escape as well? To which it may be answered, that the dis- charge of the pus-globules is preceded by the coagulation of the blood in these vessels; and that their closure, where there is a breach of continuity, is provided for by the formation of the clot keeping pace with its decomposition during the sup- purative process; and the blood corpuscle, reduced in size by being broken down, or by losing its external part, may escape, and still become enlarged out of the vessels from the addition of new matter, till it assumes the character of a true pus-globule : hence its larger and more unequal size and irregular surface than the blood corpuscle. I think my experiments will render it probable that suppu- ration is a sort of proximate analysis of the blood. As the effused fibrine produces swelling, or is attracted to the conti- guous tissue for the reparation of injury, the blood corpuscles, altered by stagnation, become useless, and are discharged in the shape of pus, as waste from the system. Suppuration, therefore, would appear to be a physiological rather than a pathological phenomenon—pus being an excrementitious dis- charge—a part of the blood which has become effete and