Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    243/976 (page 223)
    2. Medical Treatment. The treatment of a case of Pyaemia resolves itself into the treat- ment of the original lesion, the treatment of the disease, the treatment of the complications of the disease, the general hygienic treatment of the patient. . (a) Treatment of Primary Lesion.—As regards the original lesion, it has been shown that in cases where Pyaemia supervenes on wounds (whether from accident or from operation) the wounds have generally already assumed an unhealthy aspect. According to the nature of this unhealthy process must be the local treatment; but especially it would seem important that the parts should be kept clean and cool, that disinfectant applications should be employed, that free incisions to admit of the escape of pent-up pus should be made. In cases where the wound appears to be healthy, there is probably some deep- seated suppuration in progress ; and here, though the exact seat of sup- puration may be difficult to detect, it is most important that it should be detected, and the pus therein thoroughly evacuated. The same rule applies with equal force to those cases where the primary disease is an abscess involving some deep-seated bone, or tract of cellular tissue. The reasons, on which the adoption of the above plan of treatment is based, are first, that by this plan the further entrance of poisonous matters into the blood may possibly be obviated; second (and most important), that by its early adoption the entrance of poisonous matters may be wholly averted and a threatened attack of Pyaemia warded off. With the same view it lias been proposed to cauterize the superficial veins on the proximal side of the diseased part. As regards obstetrical cases, it has been asserted by some that puerperal fever is mostly preceded by an imperfectly contracted condition of the uterus; but both by those who hold this view, and by those who do not, the importance of securing complete contraction of the uterine fibres and consequent closure of the ruptured uterine veins, by the use of ergot, and other means, has been strongly urged. It lias been recommended also to cleanse the cavity of the uterus by the injection oi disinfectant and astringent fluids. (b) Curative Treatment.— Of the curative treatment of Pyaemia we fear little is known. Various plans of treatment have been