The practice of surgery . main lymph-channels of the arm, even to the axilla, are seen to bedefined as red, tender lines, following especially the course of the largerblood-vessels. One or two nodes above the external condyle maycheck for a time the process, but quickly it spreads upward to the more LYMPHANGITIS 795 numerous axillary nodes. If the disease runs unchecked, there may-result thrombi, infection of the adjacent tissues, a general breakingdown of the parts, and extensive abscess formation through the effortsof nature to combat the poison. As regards routine treatment, this is both lo
The practice of surgery . main lymph-channels of the arm, even to the axilla, are seen to bedefined as red, tender lines, following especially the course of the largerblood-vessels. One or two nodes above the external condyle maycheck for a time the process, but quickly it spreads upward to the more LYMPHANGITIS 795 numerous axillary nodes. If the disease runs unchecked, there may-result thrombi, infection of the adjacent tissues, a general breakingdown of the parts, and extensive abscess formation through the effortsof nature to combat the poison. As regards routine treatment, this is both local and general. Vaccinetherapy always should be employed whenever vaccines can be securedbut, unfortunately, in the practice of most men, vaccines, exceptstock aureus vaccines, are not available. It remains, therefore, toaccept the best local and general treatment, aside from the vaccinetreatment. The patient should be stimulated and sustained by tonicsof strychnin, iron, and whisky; his bowels and kidneys should be kept. Fig. 496.—Zander room for mechanical therapeutics at the Massachusetts GeneralHospital (formerly the old Bigelow amphitheater). active—a factor never to be neglected; he should be kept in the openair; should receive abundant simple nourishment; and, above allthings, should not be forced to depend upon his own efforts for any-thing; he should be nursed. Good local treatment consists in theencouragement of stasis hyperemia by Biers method;^ the openingof all collections of pus; and careful bandaging and support of thearm, as described in Chapter XXVI. We recognize two forms of lymphangitis: the reticular, in which aminute network of vessels is affected, giving to the skin an erysipeloidappearance; and the tubular, which affects the larger vessels only. ^ I refer the reader to the valuable publication of Willy Meyer and Victor Schmie-den on Biers Hyperemic Treatment, pubUshed in 1908. 796 MINOR SURGERY—DISEASES OF STRUCTTRE Commonly, the two foi-nis coexis
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