Surgery; its theory and practice . leisen). hands of the surgeon or nurse, and by instruments, sponges, etc., and probably by air and water. Itis now supposed to enter the system in all cases through a so-called idiopathic erysipelas, in which there is ostensibly nowound, was thought to be an exception, but as this invariably oc-curs on exposed parts, as the face, it is now beUeved that thepoison gains access through some shght crack or abrasion thathas been overlooked. The so-called cellulo-cutaneous and cellu-lar varieties have not been proved to be inoculable, and it is gen-erally
Surgery; its theory and practice . leisen). hands of the surgeon or nurse, and by instruments, sponges, etc., and probably by air and water. Itis now supposed to enter the system in all cases through a so-called idiopathic erysipelas, in which there is ostensibly nowound, was thought to be an exception, but as this invariably oc-curs on exposed parts, as the face, it is now beUeved that thepoison gains access through some shght crack or abrasion thathas been overlooked. The so-called cellulo-cutaneous and cellu-lar varieties have not been proved to be inoculable, and it is gen-erally held that they depend not upon a specific microbe, butupon the ordinary streptococcus of spreading suppuration. Inthat, however, they bear certain clinical resemblances to true orcutaneous erysipelas, they are for the present, in accordance withthe more general custom, described here with that affection. * These inoculations were undertaken for the cure of lupus and malignanttumors, and in two instances apparently with success. 7. 146 GENERAL PATHOLOGY OF INJURIES. Pathology.—The vims when inoculated multiplies in the tissues,and spreads by the lymphatic vessels and spaces. In the cutaneousform, according to Fehleisen and Metchnikotf, just beyond thespreading edge of redness where the skin is apparently normal thelymphatics are crowded with micrococci; beneath the inflamma-tory blush the vessels are dilated and the tissues softened and in-filtrated with leucocytes which are devouring the further inwards are large amoeboid cells, derived from theconnective tissue, absorbing the leucocytes and their containedmicrococci, whilst beneath the part where the blush of rednesshas faded only dead micrococci are seen. The septic productsof the micrococci, after passing through the lymphatic glands,which become swollen and tender, enter the system, producingthe constitutional symptoms. When the cellular tissue is involved,suppuration generally occurs, and the vessels th
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
