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Unformatted text preview: THE MOTTER LECTURES ON SELECTED TOPICS IN SURGICAL PATHOLOGY. SERIES OF i8go-I.'_ BY ROSWELL PARK, A.M., M.D., OF BUFFALO, PROFESSOR OF SURGERY, MEDICAL DEPARTMENT, UNIVERSITY OF BUFFALO; SUR- GEON ro THE BUFFALO GENERAL HOSPITAL, ETC. LECTURE II. WOUND INFECTION AND SUPPURATION. SYLLABUS.-Predisposition to infection, continued.-Influence of manner of inoculation and arrangement of tissue; of irritating chemical substances. Miscellaneousinfluences. Variationin susceptibility. Concurrentgrowth of vari- ousbacterialspecies. Recognitionot pyogeniccocci in thebloodasan aidtodi- agnosis. A StudyofPus.-What ispus? Differentsubstances towhich the name has beenapplied. Studyofitsgrossandminuteappearances, and circumstancesunder whichitisproduced. Virchow'sviewsastophysiological and pathological irrita- tions,andhisfourdegreesof theinflammatoryprocess. Old "humoraW theory. Cohnheim'steachingsandtheirinfluence. Can we havepuswithout micro-organ- isms? Experimentswithcadaverin. Study of the discharge from granulating wounds. Differencesbetweenacuteand chronic abscesses, and thematerialthey contain. Metastatic abscessesand lociminorisresistentiac. Minute anatomy of abscess. The "pyogenicmembrane" shouldbe called "pyophylactic"membrane. Differ- entiationofso-called pus intotruepus,ppuruloidandarchepyon. Conclusions. POINT OF INOCULATION AND ARRANGEMENT OF TISSUE. BACILLI varyvery much intheir pathogenic effects,de- pendinglargelyon the point where introduced, and the character ofthe tissuein which theyare placed. Some 'DeliveredbeforetheCollegeofPhysicians,Philadelphia,December, I890. (284) SURGICAL PA T H O O L L G Y. organisms will'not grow atlarge inthebody,but nnlyincer- tain tissues,whilethe characterof thelesionmay vary within wide limits, accordingto that of the tissue in which they thrive. The higherfungiacttobest advantage within capil- larybloodvesselsorlargeserous sacs. The bacillus of ma- lignant cedema grows only inthe cellulartissue,and thecocci of erysipelasthrivebestinthe lymphatic vesselsand cellular tissue. Cheyne had some very suggestive results in experi- mentingwiththeproteus vulgaris,which isa common sapro- phyticorganism. Introducedin quantity into subcutaneous tissueit provoked only abscesses,butthe same amount intro- duced into themuscleswould prove fatal, while a very small doseinthemuscles was sufficientto produce abscess. He suggests that possibly some chemical substance in the muscle is splitup and gives rise to poisonous compounds. Analogous resultshave been obtained with other bacteria. Fehleisenstates that about one-twelfth of the quantity of staphylococciwhich isnecessary to provoke peritonitis will cause suppurationinand aroundjoints....
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This note was uploaded on 01/16/2012 for the course BI 200 taught by Professor Potter during the Fall '11 term at Montgomery College.

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