The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . he wound. The dissection mainly extended into the intermuscular space —namely, the slit between the scaleni and the posterior border of the sterno-mastoid. iifter the removal of the mass, thefinger was easily inserted into atrack leading toward the secondvertebra, the anterior surface ofwhich was found rough and bareof periosteum. It was thoroughlyscraped and irrigated (the instru-ment could be felt in situ from theoral cavity); the outer wound wasdrained, sutured, and dress
The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . he wound. The dissection mainly extended into the intermuscular space —namely, the slit between the scaleni and the posterior border of the sterno-mastoid. iifter the removal of the mass, thefinger was easily inserted into atrack leading toward the secondvertebra, the anterior surface ofwhich was found rough and bareof periosteum. It was thoroughlyscraped and irrigated (the instru-ment could be felt in situ from theoral cavity); the outer wound wasdrained, sutured, and dressed. —High fever, with much de-jection. Skin below ear red, pain-ful, and swollen. The flap was re-opened, and a small abscess wasdetected just under the base of the flap, where probably irrigation had been insuflicient. Open treatment. Temperature fell off to normal at once. The patient was discharged cured December 1st. The other kind of infection is the dissemination through the lymphaticsof cancerous or sarcomatous cell-elements into the body caused by pressuredue to rough manij^ulation of the ¥iG. 35.—Gluteal dressiiii;-. 52 RULES OF ASEPTIC AND ANTISEPTIC SURGERY. Note.—It is a well-known fact that, in some cases of malignant tumor of slow growth, afteroperation, a large number of secondarj nodes will spring up and develop with great rapidity inthe neighborhood of the cicatrix. Two causes, either singly or combined, may be at the bottomof this phenomenon. Either the operation was incomplete—that is, the surgeons dissection hugged the tumortoo closely, leaving behind a number of outstanding microscopical foci,—or the forcible manipu-lations of the tumor during the operation have disseminated along the lymphatics and veinsembryonal cell-elements of malignant character into the vicinity of the wound or throughout thebody. This is commonly called change of the character of a malignant neoplasm, due tomechanical irritation. Undoubtedly there are man
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