Preparatory and after treatment in operative cases . ssue Destroyed and Replaced by InflammatoryProducts, Which are Breaking Down to Form Abcess Cavities, Vessels notThrombosed or Specially Inflamed. {Rupert Bucknall.) simultaneously affected; they each become centrally necrosed andthen finally, by extension, they fuse to form a multilocular abscess.(Fig. 295.) Bacteriological examination, first carried out by Girode, has servedto prove: (a) That several different kinds of organisms may give riseto secondary parotitis, the commonest being the staphylococcus, thenext frequent the pneumococcus,
Preparatory and after treatment in operative cases . ssue Destroyed and Replaced by InflammatoryProducts, Which are Breaking Down to Form Abcess Cavities, Vessels notThrombosed or Specially Inflamed. {Rupert Bucknall.) simultaneously affected; they each become centrally necrosed andthen finally, by extension, they fuse to form a multilocular abscess.(Fig. 295.) Bacteriological examination, first carried out by Girode, has servedto prove: (a) That several different kinds of organisms may give riseto secondary parotitis, the commonest being the staphylococcus, thenext frequent the pneumococcus, and after that the pneumobacillus,the typhoid bacillus, and the streptococcus, in order of frequency. PAROTITIS 469 (b) That on taking cultivations from the gland itself, the pus con-tained in it, the orifice of Stensons duct, and the oral cavity respec-tively, the organisms found at each spot are invariably identical ineach individual case, a fact which supports the conclusion that theinfection of the gland spreads from the mouth via the duct, (c). Fig. 295.—Parotitis. Showing Multilocular Abcesses in Ducts and GeneralCell, Infiltration of Lobules. (Rupert Bucknall.) That the organism giving rise to secondary parotitis is by no meansinvariably the same as that giving rise to the primary disease, duringthe course of which the attack of parotitis has arisen. Thus, in thecases complicating pneumonia, the organism causing parotitis maybe the pneumococcus or the staphylococcus; in typhoid fever, it mayoccasionally be the typhoid bacillus, but it is much more commonlythe staphylococcus or pneumococcus. In embolic parotitic due topyemia, on the other hand, the organism in the parotid is invariablyidentical with that giving rise to the primary disease and the abscessesin other parts of the body. The treatment of parotitis does not differ from that of acuteinflammatory processes elsewhere in the body. The discussionrelated above argues for cleanliness of the mouth prior to opera-tion
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