Suppuration and Abscess.
AN abscess is the collection of pus or matter in the substance of some part of the body. When the matter is poured out from some part, the process is said to be suppuration; when it collects in a tissue, it is an abscess. When the matter collecting in some organ comes towards the surface, and a place in the centre rises above the surrounding skin, and turns white, the abscess is said to point. Some abscesses point and break in a week; others of' a more chronic character will linger on for months.
Fluctuation. Before an abscess points, a fluctuation may generally be felt in the swelling, which is one of the surest signs that it contains pus. Sometimes this fluctuation maybe felt even when the matter lies very deep in the flesh. And when it is so deep that it cannot be felt, if a sudden cessation of the symptomatic fever should occur, and shiverings or rigors should come on, attended by coldness in the affected part, we may reasonably suspect that pus is formed. It is not easy, at times, to say whether matter is really present; and great care should be used not to plunge in a lancet where none exists. Chills and fever due to pus formation are caused by the absorption into the system of the poisons of ptomaines, which are the result of germ life, and their propagation.
Treatment. When the abscess is completely formed, and there is no longer any doubt of the presence of matter, it should be opened at once. To let out the confined pus alleviates the pain and lessens the inflammation. If the matter lie close to a bone, the opening should be made without delay. The opening should be large enough to let the matter out freely. It is a rule to keep the incision open till the cavity of the abscess is so far filled up that another collection of pus is not likely to occur.
If the matter do not readily get to the surface through the opening, it may burrow itself in the flesh, in a long narrow channel called a sinus. To relieve this, the opening must be extended in such a way as to give vent to the new collection.
An abscess is sometimes indisposed to heal at the bottom, and pus continues to be formed a long time, and is discharged through an opening smaller than the sack which contains it. This is a fistula, and the opening to it should be enlarged so as to let out the matter more freely. A little soft lint may then be gently pressed into the wound to prevent its healing before the cavity below. The cavity should be freely scraped out to remove all germ life, and then thoroughly disinfected and kept clean and aseptic by aseptic gauze pickings, and in this way nature is bound to heal the wound.
An abscess from acute inflammation requires to be poultices for a time after it has been opened. When the swelling and inflammation are gone, the poultices are to be laid aside, and a bandage put on. When the inflammation is gone, let the diet be improved; and if the discharge of matter be large, give wine and tonics.
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