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Apostema

Gen. I. taken place, and pus is secreted, the irritability frequently Spec. V.

Subsides; the pulse improves, the febrile exacerbations Vomica. are less frequent and violent, and the patient flatters Vomica.

himself he is recovering. The vomica at length bursts Patient sometimes

and disabuses him; he sinks gradually from the quantity fattered of the daily discharge, and the confirmed hectic; or, if into a false hope of

the disease be seated in the lungs, and the cavity exrecovery. tensive, he may be suffocated by the volume of pus that Sometimes overwhelms the trachea. suddenly suffocated. Bartholine gives a singular case of an occult vomica Singular of the lungs, that, accompanied with an asthma, proof cure. duced great emaciation; but was fortunately cured by

the wound of a sword, the point of which passed between the ribs and opened the sac. A considerable flow of pus followed, and the patient recovered gradually from

the time of the accident*. Application The method.

The methods of percussion and mediate auscultation of the methods of per- are now very generally resorted to on the continent and cussion and

and occasionally in our own country to ascertain the existence auscultation.

and extent of this affection when seated in the chest; the theory and employment of which the reader will find explained at some length, under the treatment of PHTHIsis in the ensuing volume t.

• Hist. Anat. xiv. Cent. 6.
+ Vol. ui, Cl. 11., Ord. iv. Gen. III. Spec. v.

GENUS II.

PHLEGMON E.

phlegmon.

SUPPURATIVE, CUTANEOUS TUMOUR; TENSIVE; GLA

BROUS; PAINFUL; AT LENGTH FLUCTUATING, AND
BURSTING SPONTANEOUSLY; THE PUS UNIFORM AND
GENUINE.

General

modern

Under the last genus we took a general survey of the Gen. II. process and economy of suppuration, and noticed many character of of the most extensive and dangerous forms in which phlegmon. suppuration ever presents itself. We are now advancing to inflammatory affections, consisting of tumours of small extent, and either entirely confined to the integuments, or dipping but a little way below them.

The term phlegmon, from paéyw, “ inflammo", was In what used among the Greeks for inflammation generally. It sense used

by the has long since, however, been employed in a far more Greel limited sense by medical writers of perhaps every school, loosely emthough few of them have given a very clear definition of ployed in the exact sense in which they have intended to use it; times : or perhaps have formed such a sense in their own minds.

Thus Dr. Cullen makes it comprise a multitude of tu- by Cullen ; mours or tubercles of different degrees of inflammation, some suppurative, some unsuppurative, some serous, some callous, some fleshy, some bony; as boil, minute pimple, stye, stone-pock, abscess of the breast, and spina ventosa, or carious bone; with many others altogether as discrepant; while by Sauvages it is limited, and far by Saumore correctly, to spheroidal tumours, possessing red- vages ; ness, heat, tension, violent throbbing pain, spontaneously suppurating. Not indeed, essentially different from the character now offered, and involving most of its species. Vogel, however, makes it a part of its generic character by Vogel ;

rect mean

Gen. II. that the inflammatory tumour, in order to be a phlegmon,

ne must be at least as large as a hen's egg ; while Dr. TurPhlegmon. by Turton. ton, in his useful glossary, not knowing how to reconcile

the clashing descriptions which are thus given of it, merely explains it after the Greek manner an inflammation”, leaving the reader to determine the nature of

the inflammation according to his own taste. More cor- It is necessary, therefore, to come to something more

definite; and I believe that the character now offered ing.

embraces the common idea of phlegmon; or, if not, will
propose what should seem to form a boundary for it.
And thus explained, it will comprise the following
species :-
1. PHLEGMONE COMMUNIS. PUSH.
-PARULIS. GUM-BOIL.

IMPOSTHUME IN THE

HEAD.
- PAROTIDEA. PAROTID PHLEGMON.

MAMMÆ. ABSCESS OF THE BREAST.
BUBO.

BUBO,
-

ci s

- AURIS.

inon

- PHIMOTICA.

PHIMOTIC PHLEGMON.

SPECIES I.

PHLEGMONE COMMUNIS.

Push. Common Phlegmon.

Gen. II.
Spec. I.

TUMOUR COMMON TO THE SURFACE; BRIGHT-RED;

HARD; DEFINED; HEMISPHERICAL; POLARIZED; GRA

DUALLY SOFTENING AND BURSTING AT THE POLE. In vernacular language this species is denominated a push; and in size has a near approach to a boil, or furuncle; but essentially differs from it in having its pus uniform and mature, while that of the boil is always intermixed

ne

General

with a core. It is commonly a mark of high entonic Gen. II.

Spec. I. health, or a phlogotic diathesis ; and rarely requires any phie other medical treatment than bleeding, or a few cooling communis.

Push. purgatives.

Common Where, however, pushes appear in crops, and espe- phlegmon. cially in successive crops, they support a remark we had

from a boil. occasion to make in opening the present order; that in Ge conjunction with the phlogotic diathesis there is probably character. a peculiar susceptibility of irritation ; since we frequent- Habit in

which it ly find persons in the highest health, with firm and rigid often occurs. fibres, pass great part, or even the whole of their lives, without any such affection as the present. Such susceptibility is far more common, indeed, to a habit of an opposite character, but it seems from this as well as from other circumstances, not unfrequently to inhere in the temperament we are now contemplating.

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TUMOUR SEATED ON THE GUMS; DEEP-RED; HARDISH;

UNDEFINED; PAIN OBTUSE.

This is sometimes limited to the substance of the gums; Gen. II.

Spec. II. and sometimes connected with a caries of a tooth or General socket. In the first variety it is a disease of only a few character. days' duration, and ceases almost as soon as it has burst or is opened : in the second, it will often continue troublesome till the carious tooth is extracted, or the carious socket has exfoliated : or the whole of its texture is ab. sorbed; in which case the tooth will become loose, and may at length drop out spontaneously.

Swediaur tells us that he once saw this disease produced in a man, otherwise sound, in consequence of a

Gen. II. suppression of an habitual hemorrhoidal flux, accomSpec. II.

panied with a loosening of the wise and incisor teeth. Phlegmone Parulis. In women he had frequently met with the same from Gum-boil.

obstructed menstruation*. Suppura Gum-boils, and especially where connected with a tion to be

morbid condition of the subjacent teeth, or their alveoli, encouraged,

rarely disperse without passing into the suppurative stage: and hence the means of prohibiting this termination are usually tried in vain, much time is lost, and protracted pain encountered. For these reasons it is better to encourage than to repel the suppurative pro

cess, by warm cataplasms or fomentations; and to open and the tu

the tumour as soon as it begins to point. An early opened.

opening is of importance; for, from the toughness and thickness of the walls of the abscess, it is seldom that the confined pus obtains a natural exit with sufficient freedom; while in some instances the ulceration assumes a sinuous character, or works into the substance of the

cheeks, and at length opens on their external surface. Gum-boil, The worst and most painful gum-boils are those which where se

form on the dentes sapientiæ; the swelling, from the violence of the irritation, spreads rapidly and widely; so that the entire cheek is sometimes involved in it, the neck indurated, and the eye closed.

mour soon

verest.

SPECIES III.

PHLEGMONE PAROTIDEA.

Parotid Phlegmon.
TUMOUR SEATED UNDER THE EAR; REDDISH; HARD;

PAIN OBTUSE; SUPPURATION SLOW AND DIFFICULT.

Gen. II. It is not a little singular that Dr. Cullen, who extends Spec. III.

.. the genus of phlegmone wide enough to embrace, not ranged by

• Nov. Nosol. Meth. Syst, 11. 437.

Sophere are

Cullen.

o

Nov. Nosol. Meth

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