The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . trating through theskin to tlie fascia. One or more smallfoci filled with pus will be thus their number be great, two or tlireemore parallel incisions should be engorgement or hard infiltration ofthe adjacent skin will be admirably re-moved by VolJcmamis multiple punctur-ing (Fig. 141). The blade of a narrow,straight bistoury or tenotomy knife isgrasped about one third of an inch fromits point, and is thrust in quick succes-sion thirty, forty, or, in very
The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . trating through theskin to tlie fascia. One or more smallfoci filled with pus will be thus their number be great, two or tlireemore parallel incisions should be engorgement or hard infiltration ofthe adjacent skin will be admirably re-moved by VolJcmamis multiple punctur-ing (Fig. 141). The blade of a narrow,straight bistoury or tenotomy knife isgrasped about one third of an inch fromits point, and is thrust in quick succes-sion thirty, forty, or, in very extensivecases, a hundred times through differentparts of the infiltrated region. Thepunctures should be evenly distributed. A large quantity of bloody lymph,or occasionally, if a vein be hit, pure blood will escape, and the swellingand hardness will at once be markedly reduced. No attempt should bemade to check this escape of blood or serum, as coagulation will soon stopthe flow. Thorough irrigation with corrosive-sublimate lotion, packing ofthe deeper incisions with strips of iodoformed gauze, and an ample moist. Fig. 141.—Attitude <<( liiinl \\,r multiplepuncture. (WilkMiaiiii.) DIAGNOSIS AND TREATMENT OF PHLEGMON. 187 dressinr/, held in place by loose turns of bandage, will comj)lete the immediate fall of the tem})eratnre, with marked local and general relief,will reward both patient and surgeon. Daily, later on, a rarer change ofdressings will lead to a rapid cure. If the patient declines an operation, topical applications are in , in the shaj)e of iced compresses, or the ice-bag, will be proper wherethe affection is superficial and accompanied by lymphangitis. On the whole,it may be said that cold is beneficial in the initial stages of most phlegmon-ous affections, and is often very well borne and efficacious in the milderforms. To many it becomes unbearable from the time that suppurationis well established, and often induces a severe chill, the
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Keywords: ., bookcentury1800, bookdecade1880, bookpublishernewyo, bookyear1888
