Surgery : its theory and practice / by William Johnson Walsham.

  • Walsham, William Johnson, 1847-1903.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    28/1036 (page 14)
    injury, and may be studied in its simplest form in the healing of an incised wound by the first intention (see Wounds). Should suppuration occur it is generally due to the presence of certain pyogenic micro-organisms (see Suppuration, p. 23). Septic inflammation depends upon fermentation or putrefaction in a wound or serous cavity set up by the pi'esence of saprophytic bacteria; it spreads beyond the original seat of injury, and is accompanied by constitutional symptoms of blood-poisoning [septic fever, sapr&mia). The septic products soak into the tissues, where they act like other chemical irritants, and so set up wider and wider circles of inflammation, and entering the general blood- stream with the serum which is drained away by the lymphatics, give rise to septic poisoning. They do not multiply in the living tissues, like the micro-organisms producing the infective inflam- mation to be next described. Hence as soon as the fermentation or putrefaction can be checked the spreading of the inflammation and septic poisoning have a tendency to cease. Septic inflam- mation is often accompanied by suppuration, but this is regarded as a complication depending on the presence of pyogenic micro- organisms (see Suppuration). Some surgeons include under the term septic all inflammations attended by suppuration and the various specific inflammations, as erysipelas, which are here called infective. The infective variety is also of a spreading character, and depends upon the presence of special micro-organisms (pathogenic bacteria). Unlike the products of putrefaction these micro- organisms multiply and thrive in the living tissues and in the blood-stream. They may also under certain circumstances become lodged in the lymphatic glands and in the capillaries of distant tissues and organs, where they give rise to inflammations similar to that at the seat of primary inoculation. Like the septic, the infective inflammations are generally accompanied by severe constitutional symptoms. The micro-organisms may enter, it is thought, either through a wound or through the respiratory or alimentary tract; and though not essential, a septic wound favours their admission. (See Infective processes in wounds.) It must be remembered that whether an inflammation is septic or infective, 'in both cases the lesions and symptoms are due (a) to the presence of bacteria, and (b) to intoxication, the only difference being that in one ease the bacteria are saprophytic and in the other parasitic. Inflammation also admits of other divisions; thus it ^variously spoken of as traumatic, idiopathic, strumous, syphilitic, gouty (fee, according to its supposed cause ; as adhesive, suppurative, and ulcerative, according to its termination, (fee. The treatment of inflammation may be divided into the