. The principles of surgery . lso, no doubt, of a lowgrade; and, as such, continues for some time; attended by exudationof a plastic character, which becomes organized and transformed. But„. n_ in the centre of the so inflaming part, as usual, in- crease in action occurs; the suppurative crisis isreached there; and the matter, when secreted, islimited and confined by the condensed bone justformed. This barrier serves both a good and aninjurious end. It is plainly analogous to the limitingfibrinous exudation in abscess of the soft parts; butis not alike salutary. For while it protects the sur-r
. The principles of surgery . lso, no doubt, of a lowgrade; and, as such, continues for some time; attended by exudationof a plastic character, which becomes organized and transformed. But„. n_ in the centre of the so inflaming part, as usual, in- crease in action occurs; the suppurative crisis isreached there; and the matter, when secreted, islimited and confined by the condensed bone justformed. This barrier serves both a good and aninjurious end. It is plainly analogous to the limitingfibrinous exudation in abscess of the soft parts; butis not alike salutary. For while it protects the sur-rounding parts from purulent infiltration and conse-quent disruption, it also prevents, from its density ofnature, anything like accommodating expansion be-fore the accumulating pus; increasing greatly thepain and constitutional affection, and tending toaggravation of the original disorder. Unless relief Fig. 117. Limited internal abscess in lower part of tibia. Section of bone. Pre-pared in Royal College of Surgeons INTERNAL ABSCESS OF BONE. 405 be afforded, a more formidable inflammation will invade the wholeaffected part; including ulceration and necrosis, more or less destruc-tive, with proportional aggravation of constitutional disorder. Sometimes the suppurative crisis is not preceded by a persistentminor grade of action; and, in such cases, there is little surroundingcondensation; indeed such barrier may be scarcely appreciable. Ten-dency to diffusion is consequently great; rendering the progress of thecase less protracted, but not less destructive. In any case, it is not to be supposed that the limited condition of theabscess is prone to long continuance. The tendency is otherwise ; todiffusion. Suppurative inflammation having taken place around, thecharacters of limitation are quickly swept away ; and the limited ismerged in the diffuse and more frequent form. At the same time, ifinflammatory accession remains aloof, the limited form may endure formany months
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