Modern surgery, general and operative . uid by striking the mass with afinger of the other hand. Fluctuation cannot be obtained if the amount offluid is small. It should never be sought for across a limb, but rather along it,because a false sense of fluctuation can always be obtained across the musclesof the limb. Pointing and surface edema have been discussed. A suspected abscess in a part containing large blood-vessels under no cir-cumstance should be opened by a bistoury without knowing that the diagnosisis certainly correct. This knowledge is obtained in some cases by insertinga small aspi
Modern surgery, general and operative . uid by striking the mass with afinger of the other hand. Fluctuation cannot be obtained if the amount offluid is small. It should never be sought for across a limb, but rather along it,because a false sense of fluctuation can always be obtained across the musclesof the limb. Pointing and surface edema have been discussed. A suspected abscess in a part containing large blood-vessels under no cir-cumstance should be opened by a bistoury without knowing that the diagnosisis certainly correct. This knowledge is obtained in some cases by insertinga small aspirating needle and observing the nature of the fluid which operation must be performed with aseptic care; otherwise, if there is noabscess, infection may be inaugurated; if there is an abscess, mLxed infectionmay occur. The older operators used a grooved exploring needle, but manyable surgeons object to its use, on the ground that when plunged into an in-fected area pus bathes the track of puncture and may cause infection of. Fig. 77.—Vischers case for caroing culture-tubes for inoculation. other tissues and diffusion of the pyogenic process. The tubular exploringneedle is the proper instrument. An abscess which moves with the pulse because it rests upon an arterymay be confounded with an aneurysm. The pulse movements of such anabscess are in one direction only; the abscess is lifted with each pulse-beat,but does not enlarge, and if a finger is laid upon either side of it the fingerswill be lifted, but not separated. The pulse movements of an aneurysm arein all directions; they are expansile, the sac grows larger, and the fingerswill not only be lifted, but will also be separated. The small tubular exploringneedle may be used in doubtful cases; if aseptic, it will do no harm even to ananeurysm. A rapidly gro\;\ing, small-cell sarcoma feels not imlike an abscess,but the exploring needle discovers blood and not pus. A cystic timior isseparated from an abscess by the
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
