. American practice of surgery ; a complete system of the science and art of surgery . to be affected at the same time. Insuitable cases, after the removal of nodes which seem to be lymphosarcomata,animal injections should be made, since Fischer records a case in which abun-dant eosinophilic cells, lymphocytes, and a few epithelioid cells were found, butno giant cells, retrograde changes, or tubercle bacilli. Yet inoculation of rab- 548 AMERICAN PRACTICE OF SURGERY. bits demonstrated the existence of tuberculosis, and the chnical course of thedisease supported the diagnosis. Syphilitic nodes m


. American practice of surgery ; a complete system of the science and art of surgery . to be affected at the same time. Insuitable cases, after the removal of nodes which seem to be lymphosarcomata,animal injections should be made, since Fischer records a case in which abun-dant eosinophilic cells, lymphocytes, and a few epithelioid cells were found, butno giant cells, retrograde changes, or tubercle bacilli. Yet inoculation of rab- 548 AMERICAN PRACTICE OF SURGERY. bits demonstrated the existence of tuberculosis, and the chnical course of thedisease supported the diagnosis. Syphilitic nodes may resemble tuberculous nodes, but they are usually accom-panied by other signs of syphilis. These signs should always be looked for, andin doubtful cases antisyphilitic treatment should be used. Branchial cysts are often mistaken for tuberculous nodes. They are usuallysingle, however, but are frequently situated in the subparotid region. Whensuch a cyst is situated lower down or farther forward in the neck, it is usuallyaccompanied by a sinus ^^?hich opens near the median Fig. 172.—Photograph of a Patient with Tuberculous Cervical Lymph Nodes who had been treatedfor one year by lancing the separate nodes as they softened and dressing the running sores. The disfigure-ment from this treatment is far greater than that which comes from prompt operation. Fig. 173 showshow many diseased nodes still remained after this course of treatment. (St. Marys Hospital for Chil-dren, New York.) Actinomycosis is uncommon in this locality. It is usually accompanied bya granulating surface, and the ray fungus can be found. Treatment.—Many forms of treatment have been used for this disease, allthe way from the kings touch to radical removal, and the history of medi-cine might be well sketched in studying the methods which have been devisedfor the treatment of scrofula. Medication and hygienic measures are followedby a cure in a certain proportion of cases. Iodide of potassium, arsenic,


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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906