Southern Medical and Surgical Journal - Georgia Regents University

;514 Miscellaneous. [Marchsanguinis into the connective tissue, and its transformation,under the influence of heat, into what is calledpurulent fluid. When to the part in this state we applymoist heat, we quicken suppuration, mainly by upholdingthe temperature : at the same time, we secure the transferenceof water from the moist surface into the fluids ofthe inflamed part, by which tension of tissues is produced,and in the end yielding of tissue at the weakest point.When the suppurating surface is circumscribed, therapid induction of the process may be attended with littleinjury ; but when the surface is large and when the exudedfluidis thrown into loose structures where it can burrowreadily, the practice, I think, can not be good to extendthe mischief.Hence, in the treatment of carbuncle andphlegmonous erysipelas, it can not, I opine, be soundpractice in the early stage to apply moist heat. Experiencealso, not less than principle, warrants this conclusion.In cases of carbuncle especially, I have of late altogetheravoided the application of moist heat in the early stagesand, I feel assured, with good results.But when, in the course of local disease, suppuration isactively established, and is naturally circumscribed ; whenthe increased temperature of the part has fallen to orbelow the natural temperature—then the value of moistheat comes on with full force ;then the tension which isexerted determines the escape of fluid at the weakestpoint of the surrounding tissue, and, when the fluid escapesor is liberated by the knife, the escape for a longperiod is aided by the application of moist heat.The continued application of moist heat for a long timeafter the escape of purulent fluidis again, I conceive, indifferentpractice. It sustains discharge; it sets up unhealthydecomposition of fluids ; it produces a thickenedsoddened condition of skin, most favorable to the productionof sinus ; and it retards recovery. When a surface