Swelling

“ Subsequently many distinctions were drawn; a phlegmonous affection combined with swelling was called a βουβὼν (bubo) , while the name φῦμα (swelling) was appropriated to a swelling of the glands characterized by its rapid establishment and its tendency to suppuration (bubo with suppurative pustule in the centre) , and φύγεθλον (burning swelling) to one conjoined with (cutaneous) inflammation of an erysipelas character,408 which last form, if it passes on into induration, is known as χοιρὰς or struma (scrofulous or strumous swelling) . ”

“ Fever, pain in the limbs, swelling of the joints, sweats unattended by that relief which usually accompanies abundant action of the skin in fevers, are its characteristics. In the child all these symptoms are usually less even than in the adult. The swelling of the joints in particular is less considerable, and both the pain and the swelling are apt to wander from one to another joint, or to a different limb, instead of remaining fixed as they do in the grown person for several days in the same joint, even though fresh joints may be implicated in the course of the disease. ”

“ In some cases the swelling is so great or occurs so close to the larynx that the breathing is interfered with, and even rendered so difficult that suffocation is threatened. In other cases the disease assumes an irregular form, and the swelling, instead of softening in the centre, remains hard for an indefinite time, or it may subside and abscesses form in various parts of the body, sometimes in vital organs, as the brain, lungs, liver, kidneys, &c., or in the bronchial or mesenteric glands, where they generally produce serious consequences. ”

“ 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. ”

“ A person is suffering pain in the joints of the right hand, but has also an acute swelling in the bladder, the kidneys or the womb. Now, I say that in such a case we ought not to bleed from the hand, because if we do we shall injure the organ affected by the swelling. Perhaps, however, we may bleed from the right foot, provided we understand that there is on the right side a sanguineous tumor, the danger of which is greater than that of the swelling on the right hand. ”

“ And may not the same thing happen in local inflammations, where, so long as the swelling is on the increase, and has not reached its extreme term, a full pulse is felt in the part, especially when the disease is of the more acute kind, and the swelling usually takes place most rapidly. ”

“ Heat and tenderness are present, and the animal is lame.
Later the inflammatory swelling becomes more profuse, the animal is fevered, and the symptoms of lameness increased. Poulticing is at this stage perhaps resorted to. By its means the process of suppuration is aided, and the swelling (at first tense and hard) either becomes gradually softened, its contents discharged, and a simple abscess cavity left behind, or the suppuration runs immediately round the necrosed structures, and casts them off bodily as a slough. ”

“ This combination of redness and swelling extends, and its area is sharply defined from the healthy skin. The color at once fades on pressure and returns immediately the pressure is removed. In the hyperemic area, vesicles or bullae form, [Pg 136] containing first serum and later possibly sero-pus. Edema affects the subcutaneous tissues, producing great swelling in the regions where these tissues are lax.
Treatment. Isolate the patient; asepticize the wound; and give a purge. If a person is debilitated, stimulate freely. ”

“ But I never saw any Person suffocated or starved by this Swelling and Inflammation of the Throat; for by the Assistance of softning, cooling and astringent Gargarisms and Injections of the same Kind by the Syringe, and in more difficult Cases by opening the Veins under the Tongue, or by the Course of Nature in such Inflammations, and the subsiding of the Swellings themselves, after such a Period of Time, the Symptoms have been always removed, and the Sufferer relieved. ”

“ The part is swelled and red, and the redness is diffused. After a short continuance, the swelling increases at some points, often about the root of the nail, from effused fluid betwixt the cuticle and rete mucosum; the fluid is sometimes serous, generally sero-purulent. In the deeper-seated inflammation, the pain, throbbing, heat, and swelling, are all greater. The pain is more intense, and almost intolerable, allowing the patient little or no rest; and the throbbing extends to the vessels of the hand and forearm. A considerable degree of fever attends. ”

“ But if the humors are hard and dry, they are confined within the interior of the organs, such as bones, nerves and membranes: and these, being hard in themselves, do not receive the moisture, nor suffer extension or dilatation, and thus no swelling results. Since, therefore, the material of this variety of arthetica, in which no swelling is present, is formed of grosser and harder substance and is found in the vicinity of hard and cold localities, it is dissolved slowly and the disease is not cured until this solution takes place. ”

“ Symptoms.—A fullness or a swelling is first noticed in the groin, which is made worse in standing, coughing and lifting. This disappears on lying down and reappears on rising in many cases, even at first; coughing makes the lump or swelling harder. It may come on both sides, when it is called double rupture or hernia.
MOTHERS' REMEDIES.—Rupture, Poultice for.—"Take equal parts of lobelia and stramonium leaves; make a poultice and apply to the parts. Renew as often as necessary. This combination makes a very effective poultice and is sure to give relief." ”

“ The essential difference between the primary and the secondary swellings is to be found in the fact that, although the bone be exposed, and even in some degree may have changed its color in the primary swelling when matter has formed, the febrile symptoms will subside after its evacuation, healthy granulations will spring up, and little or no exfoliation will take place. In the secondary swelling none of these favorable symptoms or appearances will take place, for the bone is incapable of maintaining its life, and must die. ”

“ The symptoms are pain, swelling, heat, and redness, a conical projection on the swelling, often with a white point at the apex. Abscess or suppuration may come on any part of the body. When the local inflammation does not yield to cold lotions, apply poultices; a pledget of lint dipped in cold water and kept moist by means of oil-silk; a slice of bread softened with boiling water or milk, or linseed meal, make the best poultices. Should the pain be severe add laudanum, and additionally rub it round the swelling. ”

“ The following symptoms occur in local inflammation. Increased heat in the part is an important symptom. It is due to the increased blood-flow to the part. Because of the pigmented, hairy skin of domestic animals, redness is of little value in locating superficial inflammation. Swelling is a valuable local symptom. It is produced by the inflammatory exudates. Pain results from the pressure on the sensory nerves by the inflammatory swelling. For example, the laminae of the foot are imprisoned between the horny wall and the pedal bone. ”

“ The density of the powdered skin may also be determined in the air volumenometer (Say; Kopp. Kohlrausch Physical Measurements, p. 53) .
Swelling and Falling.—The skin, in its living condition on the healthy animal, is the most supple and perfect of coverings, and in producing soft leathers it is the object of the tanner to retain this supple condition. To do this, the swollen fibres must, as we have seen, be got back to their natural state. The phenomena of swelling and depletion of skin have been discussed by Körner,51 and recently Prof. ”

“ There comes a white swelling or scab, with a change of the color of the hair on the part from its natural hue to yellow; then the appearance of a taint going deeper than the skin, or raw flesh appearing in the swelling. Then it spreads and attacks the cartilaginous portions of the body. The nails loosen and drop off, the gums are absorbed, and the teeth decay and fall out; the breath is a stench, the nose decays; fingers, hands, feet, may be lost, or the eyes eaten out. ”

“ Definition.—This is a contagious disease causing the inflammation of the salivary glands, and is generally a disease of childhood and youth.
Symptoms.—A slight fever, stiffness of the neck and lower jaw, swelling and soreness of the gland. It usually develops in four or five days and then begins to disappear.
Home Treatment.—Apply to the swelling a hot poultice of cornmeal and bread and milk. A hop poultice is also excellent. Take a good dose of physic and rest carefully. A warm general bath, or mustard foot bath, is very good. Avoid exposure or cold drafts. ”

“ Sometimes this swelling attacks both ears. It usually lasts about a week. The child should be kept in bed to prevent [Pg 210] taking cold. Mild cathartics will do no harm; and a fluid or semi-fluid diet should be supplied while there is temperature. The swelling can be covered by an ordinary cotton-batting bandage, unless the pain is very severe, when it can be soothed by hot compresses. Quarantine should be maintained for three weeks from the appearance of the swelling.
Among the nursery emergencies which are not contagious croup may be mentioned first, because it is the most common. ”

“ When the swelling is much raised up to a point, unconcocted, thin, and devoid of vitality, we must cut out a piece either like a triangle, or like a myrtle leaf, or of some other angular figure, because the circular is unfavorable to cicatrization. Those which are not pointed we open by a simple incision, and when we find a sinus, if the part is fleshy and the skin proper for uniting, we only make such incisions into the part as will allow the matter to be discharged; but if it be thin and very devoid of flesh we make a simple incision along its whole length ”

“ The pain of the swelling was in particular very violent, and to some intolerable; the physicians and surgeons may be said to have tortured many poor creatures even to death. The swellings in some grew hard, and they applied violent drawing-plaisters or poultices to break them, and if these did not do they cut and scarified them in a terrible manner. ”

“ The first symptom is usually a swelling of the joint and its vicinity. There is no redness or heat and no pain on movement. The peri-articular swelling, unlike ordinary oedema, scarcely pits even on firm pressure. ”

“ When the disease begins with swelling, which is of a chronic character, and produces but little inconvenience, and when the more urgent symptoms supervene after the swelling has continued for a considerable time, there is every reason to suppose that the disease has originated in the synovial membrane, or perhaps in the osseous cancelli, and this is generally met with in poorly fed and strumous subjects. ”

“ Great swelling occurs almost immediately, attended with excruciating pain, and extends upward along the limb; vision becomes impaired, the patient lies in a state of stupor, and ultimately succumbs under convulsions and delirium; the symptoms vary in particular instances according to idiosyncrasies and the state of the constitution when the injury is inflicted.22 In this country, the bites of rabid animals are more dangerous than those of animals naturally poisonous. ”

“ If the lungs be the seat of the disease, as is the case when horses are first attacked with coughs, we cannot recommend a better treatment to be pursued than that pointed out, p. 82, in the article Cough. But, if a swelling arise beneath the ears, jaws, or about the root of the tongue, proper and immediate applications should be made to procure a discharge and suppuration of the matter. ”

“ But if the noxious Matter is discharg’d upon the Muscles of the Throat, it proves a Quinsy, or a painful Swelling of the Tosills; if on the internal Skin of the Chest or Thorax, a Pleurisy; if on the Lungs a Peripneumony; if on the Liver, Kidney, Bladder or Guts, it produces hot painful Swellings, which by Degrees often ulcerate, and sometimes mortify. ”

“ Symptoms.—While eating, or shortly afterward, a swelling appears on the left side, and as the swelling increases the animal appears to be in great distress, pants, strikes belly with its hind feet, the belching of gas is noticed and the animal does not chew its cud. Later the breathing becomes difficult, the animal moans, its back is arched, eyes protrude, the tongue hangs out and saliva runs from the mouth. ”

“ In some cases the first symptom noticed is a swollen and painful gland, but fever soon manifests itself. The glandular enlargement may antedate, coincide with, or follow the rise in temperature. Sometimes only pain in the gland is complained of, but no swelling is observed. ”

“ In cases, where a considerable swelling attacked the upper part of the joint, a circumstance which occasionally occurs in practice, one or two bleedings, a diet more or less strict, and the use of diluent drinks, constituted the internal treatment. ”

“ Often the swelling extends no higher than the ankles, but it may involve the calves, the thighs, or even the vulva, which is the region between the thighs.
If the swelling remains slight, no attention need be paid to it. But if it becomes extensive or painful, nothing will give relief except going to bed. Patients observe for themselves that the swelling lessens during the night, and from this usually learn that the proper treatment is rest. ”