. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. onesfractured. The blood-vessels and lymphatics areinjured, giving rise to effusion into the newly formedsubcutaneous space and bulging of the skin. Ifthe larger blood-vessels are torn there is subcutane-ous effusion of blood and dark-red discolorationof the skin, forming an extensive tense swellingwhich generally disappears quickly. If the largerlymphatic vessels are torn, as usually happens,the lymphatic effusion often appears several hoursafter the injury. The skin is hardly altere
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. onesfractured. The blood-vessels and lymphatics areinjured, giving rise to effusion into the newly formedsubcutaneous space and bulging of the skin. Ifthe larger blood-vessels are torn there is subcutane-ous effusion of blood and dark-red discolorationof the skin, forming an extensive tense swellingwhich generally disappears quickly. If the largerlymphatic vessels are torn, as usually happens,the lymphatic effusion often appears several hoursafter the injury. The skin is hardly altered, per-haps somewhat livid and excoriated, while thesubcutaneous swelling subsides slowly, owing to thelong, continual effusion of lymph. The lymphatic effusion, which is generally more orless mixed with blood, accumulates in the dependentparts of the injured region. Fluctuation of the fluidin the subcutaneous cavity can be felt. Treatment. Subcutaneous effusion of blood soonundergoes spontaneous absorption. The lymphaticeffusion gradually disappears after repeated punc- 148 Bockeiiheimer, Atlas. Tab. LVl. Iigf. 73. Dclacluiicnt of tlie Skin. P^hmsn rrtmn^ni- M^^-rlf ture, injection of tincture of iodine and compressionby bandages. Incision should only be performed ifthere is suppuration. Fig. 73 shows a detachment of the skin resultingfrom a blow on the left elbow. A few days after theinjury effusion took place in the subcutaneous cavity,chiefly in the forearm. The cavity was not com-pletely filled so that several swellings are is a slight abrasion of the skin over the ole-cranon, the appearance and direction of which showthat the blow was a tangential one. The skin is lividover the whole swelling. Yellowish fluid was evacu-ated by puncture, showing very slight mixture withblood. Submucous effusion in the nasal septum and in thelarynx may also be caused by the action of tangentialforce (generally foreign bodies). Here also the effu-sion only occurs where the submuc
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