File:The principles and practice of modern surgery (1847) (14597683508).jpg

Identifier: principlespracti00drui (find matches)
Title: The principles and practice of modern surgery
Year: 1847 (1840s)
Authors: Druitt, Robert, 1814-1883 Flint, Joshua B. (Joshua Barker), 1801-1864
Subjects: General Surgery Surgery
Publisher: Philadelphia : Lea and Blanchard
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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of a super-ficial layer of bone, without the formation of a shell of new bone, as innecrosis. It is generally caused bysome mechanical or chemical injury, orby stripping off the periosteum. Not,however, that stripping off the perios-teum is invariably followed by exfolia-tion ; for the bone may remain redand moist, and throw out granulations;whereas, if it be about to exfoliate, itbecomes white and dry. Treatment.—A lotion of weak nitricacid may be useful; and the exfoliatingportion should be removed as soon as itcan be detached. IX. Caries is an unhealthy inflam-mation of bone which essentially pro-duces softening, and probably leads toulceration and suppuration. Pathology.—The bone is soft andred; its cells are filled with a red serousor thick glairy fluid;—and in scrofulouscases there is also a deposit of more orless tubercular matter. The bone, whenmacerated and dried, looks soft andspongy; eaten into hollows, and throwninto irregular elevations, at the site ofgranulations.
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* The chloride of zinc has also been used to make a hole in the new shell. ^Vide p. 208. t This cut displays a state formerly termed spina ventosa, in which the interior of a boneis hollowed out by caries whilst fresh bone is deposited on the circumference. The bonemost frequently so affected is the head of the tibia. 220 TUMORS OF BONE. Symptoms.— The external character of the limb, says Mayo, isthe same in necrosis and caries. The bone appears enlarged, and XDneor more sinuses open from it at points that are soft, and red, and sunken.If a probe is passed into these, it will readily break down the softenedtexture of the carious bone which yields a gritty feel. Causes.—Caries most frequently attacks bones of a soft, spongy tex-ture ; such as the vertebrae, the round and flat bones, and the articu-lar extremities of long bones. Its genuine cause is some constitutionaldisorder, scrofula, syphilis, or mercury. Treatment.—The indications are twofold ;—to rectify constitutionaldiso

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