Researches on suppuration. Sect. 1. On the frequent presence and on the effects of pus in the blood, in diseases attended by inflammation and suppuration / by George Gulliver.

Date:
[1838]
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Credit: Researches on suppuration. Sect. 1. On the frequent presence and on the effects of pus in the blood, in diseases attended by inflammation and suppuration / by George Gulliver. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    of such cases, it would not be advantageous to produce sup- puration as soon as possible on the surface of the body, so as to establish a drain by which the blood might be deprived of the offending matter. It may be asked also, whether the be- nefit so often effected by blisters, setons, and issues, in certain internal inflammations,—or by incisions, which cause sup- puration, in inflammatory affections of the integuments, be not explicable by this theory? It is well known that in cases of traumatic or idiopathic inflammation, attended with great swelling and febrile excitement, the establishment of suppu- ration in the part is generally a favourable symptom, the se- paration of the pus from the blood being a sort of crisis to the symptomatic fever. In small-pox, it is a popular belief that “ the striking in,” as it is termed, or suppression of the pus- tules, is a bad symptom; and this is so far true, that the worst cases of this disease are those in which there is great swelling of the integuments without the due formation of pus in the usual situation. In every instance in which I have ex- amined it, I found pus in the blood of patients affected with small-pox. In the fourth and fifth experiments the pus which was in- jected into the serous sacs would appear to have been absorbed. A more careful inquiry, however, would be requisite to warrant this conclusion; for in some experiments made by Dr. Davy, the quantity of matter injected seemed to be increased; and I have since made an experiment with the same result. The absorption of pus being the cause of hectic fever is an old hypothesis, which the detection of pus in the blood in cases of chronic abscess and in pulmonary consumption might be supposed to confirm. It does not seem necessary, how- ever, to assign two causes for one effect. When pus in large quantities is incessantly forming in the capillaries, it is easy to imagine how it may become mixed with the blood. I have related instances of pus in the blood, independently of suppuration out of the vessels: this fact appears to be of some importance, for it must be inferred that the pus was not absorbed, but formed in the blood. If it be objected to some of the foregoing views, that pus and extravasated blood are often absorbed without any ill effects, and that no constitutional disturbance may ensue after inflammation and the consequent effusion of fibrine—it may be remarked, first, that pus and blood are probably absorbed in a modified state; and secondly, that a small quantity of pus, like other poisons, gradually added to the circulation may not be productive of bad symptoms. The sixth and seventh experiments may be cited in illustration. It is pro-