Pus

“ While laudable pus was for centuries after his time supposedly a scientific doctrine, Theodoric did not think so, and emphatically insisted that such teaching represented a great error. He said: “For it is not necessary, as Roger and Roland have written, as many of their disciples teach, and as all modern surgeons profess, that pus should be generated in wounds. No error can be greater than this. Such a practice is indeed to hinder nature, to prolong the disease, and to prevent the conglutination and consolidation of the wound.” ”

“ It is no objection to this theory of dropsy, that we sometimes find water in the cavities of the body after death, without any marks of inflammation in the contiguous blood-vessels. We often find pus, both in the living and dead body, under the same circumstances, where we are sure it was not preceded by any of the obvious marks of inflammation. ”

“ Some bacteria and some white blood corpuscles are killed, and substances are formed which liquify these dead cells and also some cells of the surrounding tissues. The resulting fluid is called pus or matter, and in the case of a boil we then say it has come to a head. If the infection occurs near a cavity or near the surface of the body, the pus may escape by breaking through at the point of least resistance, and may carry most of the poisons along [223] with it. If the pus finds no outlet it may be gradually absorbed by the blood stream, and healing may result without discharging. ”

“ When pus is formed in a well-maintained system and tissue, the outer layer of the lymph is developed into a fibrous sac enclosing the liquid pus and constituting an abscess. In an unhealthy system, or when the inflammation depends on some injurious poison, like that of erysipelas, this sac may not be formed, and the pus, burrowing into and between different organs, destroys the connections and substance—diffuse suppuration. ”

“ Large quantities of pus are discharged in consumptions attended with abscesses, and yet few die of them, where they have not been preceded by long continued debility of the whole system. No pus is expectorated from tubercles, and how generally fatal is the disease, after they are formed in the lungs! It is only after they ulcerate that they discharge pus, and it is only after ulcers are thus formed, that the consumption probably becomes uniformly fatal. ”

“ At all events, so poorly are these pus-germs able to preserve their vigor and power of attack, not merely outside of the human body, but outside of some wound or sore spot, that it is practically certain that eight-tenths of all cases of wound-infection or blood-poisoning come directly from some previous festering wound, sore, ulcer, scab, boil, or pimple, in or on some other human being or animal. Practically whenever we get pus in a wound in a hospital, we insist upon finding the precise previous case of pus from which that originated, and seldom is our search unsuccessful. ”

“ As the inflammatory stage commences, the formation of pus is increased, which changes from a thin to a thick yellow color, accompanied by a severe scalding on making water. The inflammation increases up to the fifth day, often causing such pain, on urinating, that the patient is tortured severely. ”

“ The pus infiltrates the meshes of the cellular tissue, there is sloughing of considerable portions of tissue of low vitality, such as fat, fascia, or tendon, and if the process continues for some time several collections of pus may form. ”

“ Likewise, an ulcer, in a weak and emaciated person, which is located within the cavity of the abdomen, (Koshtha) and which assumes either a black or yellowish colour, and exudes a secretion composed of urine, pus, blood and fecal matter, which finds its outlet both through the upward and downward fissures of the body (the mouth and the anus) making a rumbling, gurgling sound, or which simultaneously secretes pus and blood through both the channels, should be regarded as belonging to the incurable class. ”

“ The softening of the swelling is not a mere change of solid substance into a fluid, as if by decay, but it is the result of an active process, which we call suppuration. When this process is properly performed, good pus is made, or as the old writers in medicine rather quaintly expressed it, laudable pus. ”

“ The external examination of the body, before handling, is a matter not to be neglected. Should any syphilitic sores or foul ulcers be present, the utmost caution must be used in handling the body, as the pus, which is a most virulent poison, might find its way into the system through some abrasion of the skin. ”

“ Pus is present in considerable quantity in the cavity, and the ulceration of the costal pleura and the soft walls of the chest allows the fluid to flow outward and air to enter the cavity. Or there may be necrosis of parietal pleura into a bronchus and consequent discharge of pus through the mouth. The lung is already disabled. The violent pain in the side and the dyspnoea are no longer found. Indeed, the exact time of the rupture and commencement of the discharge is frequently unknown to the patient himself. ”

“ But usually the boil increases in size for several days, until it may be as large as a pigeon's egg. It assumes a bright-red sharply defined, rounded shape, with a conical point, and is at first hard and then softens as pus or "matter" forms. There is [Pg 158] severe pain of a throbbing, boring character, which is worse at night, and destroys the patient's sleep and appetite. There may be some fever. The glands in the neighborhood may be enlarged and tender, owing to some of the pus germs' escaping from the boil and lodging in the glands. ”

“ When the slough gives way the pus escapes and, tension being relieved, pain ceases. A local necrosis or death of tissue takes place at that part of the inflammatory swelling farthest from the healthy circulation. When the attack of septic inflammation is very acute, death of the tissue occurs en masse, as in the core of a boil or carbuncle. Sometimes, however, no such mass of dead tissue is to be observed, and all that escapes when the skin is lanced or gives way is the creamy pus. ”

“ The simple experiment of mixing some pus with healthy, recently drawn blood, will at once shew that such a combination cannot circulate in the living body. It will be found that the blood coagulates round the globules of pus, and forms a solid mass which will adhere to the first surface with which it comes in contact; and it will be evident, that it is not till the coagulum thus formed is broken up or dissolved, that its elements can circulate with the blood. ”

“ My bladder became very painful and commenced to ulcerate and fill up. It seemed from the excruciating agony I suffered, that there must have been an abscess in either the kidney or bladder, and from the large amount of pus discharged at one time, it appeared to me that my kidneys, bladder and the entire urinary organs were one mass of sores and pus mixed with blood. I had to use injections of laudanum daily in the lower bowels to ease the pain and live. Was reduced by long suffering, looking for each day to be my last. I felt that no human power on earth could help me. ”

“ If the liniment is applied late in the vesicular stage, or not until the pustular stage has set in, the carbolised oil penetrates more or less into the epidermis which is being thrown off by the suppuration of the pustule; as the pus is discharged by rupture of the epidermis the oil mixes with the pus, disinfects it, and keeps it sweet, as is to be observed by the entire non-existence of, or extremely modified condition of, the horrid stench that accompanies small-pox, subsequent to the pustular stage of the disease. ”

“ Where pus has formed in relation to important structures--as, for example, in the deeper planes of the neck--_Hilton's method_ of opening the abscess may be employed. An incision is made through the skin and fascia, a grooved director is gently pushed through the deeper tissues till pus escapes along its groove, and then the track is widened by passing in a pair of dressing forceps and expanding the blades. A tube, or strip of rubber tissue, is introduced, and the subsequent treatment carried out as in other abscesses. ”

“ They feel either extremely hard or soft to the touch and present either a raised elevated or a depressed aspect. They are of either a black or red, yellow or white colour, and are characterised by extremes of temperature. Exhibiting strange and unusual features, they are checkered with networks of veins, ligaments, etc., and are filled with putrid and sloughing flesh and fetid pus. Indefinite and irregular in shape, they are found to exude a sort of dirty, fetid pus, which runs into fissures and cavities, following an oblique or upward course. ”

“ I am certain that diseases resulting from purulent infection would not be stamped with the seal of incurability, and that nature, seconded by art, would triumph in the majority of cases, if the pus, which is incessantly renewed, did not incessantly renew the sources of infection. ”

“ Pus may be thrown off by a mucous membrane, without any actual breach of continuity. Diffuse infiltration of the tissues is the most dangerous form of suppuration.
In this variety of inflammation the exudate is brought into contact with the greatest possible extent of absorbent vessels, for as a surface of a sponge is greater than that of a bag, which would contain it, so the surface of these intercellular spaces is much greater than that of an abscess cavity filled by the same amount of pus. ”

“ We have seen how frequently large collections of pus sooner or later open either through the lung or through the chest-walls. If an opening has to be made, the more promptly the better. In the first stage, especially in acute purulent pleurisy, the slight neo-membranes and fibrinous deposits, barely solid, readily undergo granular fatty degeneration, and are absorbed if relieved of the pus. In this stage the two folds of the pleura are in their best condition for becoming adherent to each other, and by obliteration of the pleural cavity to end the disease. ”

“ It acts like chronic cold with ulcer in the nose. Some recover.
3. Acute Farcy.—The local and general signs are those of an infection, with necrosis (local death) at the site (in the skin) of inoculation; nodules, (lumps) known as "farcy buds" form along the lymphatics (glands) and form pus. There may be pus collections in the joints and muscles. Death often occurs in one to five days.
Chronic Farcy.—Tumors in the skin of the extremities, containing pus. The process is local, the inflammatory symptoms light, and the duration may be months or years. ”

“ Boils and carbuncles are almost the only instances in which pus germs can get into the body without some actual cut, tear, or breaking of the skin. They come always from other boils or ulcers or discharging wounds and are caused by the pus germs in these either being rubbed into the skin until it is almost chafed through, or else being driven down into the mouth of one of the hair follicles, or "pores." Here they proceed to grow and form a little gathering, which soon turns to pus ”

“ Except in very particular cases he disapproves of bleeding. He approves in general of discutient applications; but when the swelling tends to suppuration, he directs us to promote it; and when pus is fairly formed he recommends us to let it out, but cautions the surgeon not to attempt this operation unless he has a practical acquaintance with anatomy, lest he wound any of the veins, arteries, or nerves. ”

“ Sédillot, in which he detected the globules of pus in the blood, the patients died of the disease; but in the researches instituted by M. Dance and others, the experiments were made upon animals in perfect health. In the latter, the pus cannot enter the circulation, as has already been shewn, or can only do so after the blood has partially or entirely coagulated round it, and the coagulum has subsequently become broken up. ”

“ When it occurs on a surface, it is an ulcer, and an abscess by breaking on the exterior becomes then also an ulcer. Proliferating and dying cells, and the fluid which exudes from an ulcerating surface and the débris of broken-down tissue is known as pus, and the process by which this is formed is known as suppuration. ”

“ Pus was formerly regarded as irritating and corroding, and was therefore carefully removed from every granulating sore; but purulent matter, though it may prove a source of irritation to the neighbouring parts, does not disturb the surface which secretes it, but, on the contrary, protects the tender granulations, and acts as a temporary cuticle. A crust is formed by the evaporation of the thinner part of the fluid; and we frequently see small sores healing rapidly when thus protected. ”

“ Sometimes dried pus in the nostrils, resulting from a cold, will cause
nasal gleet.
SYMPTOMS: A white or yellowish discharge from one or both of the
nostrils, the quantity varying with the severity of the attack and the
length of time the disease has been established. If, when tapping over
the nose below the eye, a dull sound is produced, it is safe to conclude
that the cavities are filled with pus; to make certain, compare the sick
animal with a healthy one; in some cases you will notice that even the
bones of the nose below the eye are slightly elevated. ”