PART 18
When abscesses form about the ears, after peripneumonic affections,
or depositions of matter take place in the inferior extremities and
end in fistula, such persons recover. The following observations are
to be made upon them: if the fever persist, and the pain do not cease,
if the expectoration be not
[p. 54]normal, and if the alvine discharges be
neither bilious, nor free and unmixed; and if the urine be neither
copious nor have its proper sediment, but if, on the other hand, all
the other salutary symptoms be present, in such cases abscesses may
be expected to take place. They form in the inferior parts when there
is a collection of phlegm about the hypochondria; and in the upper
when the hypochondria continue soft and free of pain, and when dyspnoea having
been present for a certain time, ceases without any obvious cause.
All deposits which take place in the legs after severe and dangerous
attacks of pneumonia, are salutary, but the best are those which occur
at the time when the sputa undergo a change; for if the swelling and
pain take place while the sputa are changing from yellow and becoming
of a purulent character, and are expectorated freely, under these
circumstances the man will recover most favorably and the abscess
becoming free of pain, will soon cease; but if the expectoration is
not free, and the urine does not appear to have the proper sediment,
there is danger lest the limb should be maimed, or that the case otherwise
should give trouble. But if the abscesses disappear and go back, while
expectoration does not take place, and fever prevails, it is a bad
symptom; for there is danger that the man may get into a state of
delirium and die. Of persons having empyema after peripneumonic affections,
those that are advanced in life run the greatest risk of dying; but
in the other kinds of empyema younger persons rather die. In cases
of empyema treated by the cautery or incision, when the matter is
pure, white, and not fetid, the patient recovers; but if of a bloody
and dirty character, he dies.
