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Diseases of Lymphatic Vessels and Glands

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DISEASES OF LYMPHATIC VESSELS AND GLANDS.

Inflammation of Lymphatic Vessels (Lymphangitis, also called Angioleueitis, from Greek angeion, a vessel, and leukos, white). —This most commonly results from the intro duction under the skin of some irritating material, which, as explained on p. 279, is picked up by the lymphatic vessels, and sub sequently irritates them. Medical men and students run risks of it, coining in contact as they do with so many foul discharges. The smallest break in the skin, even that made by a pin point, may afford entrance to poisonous stuff, which begins to manifest its presence within a few hours after its introduction. In jury may also set up the inflammation.

Symptoms.—The chief evidence of the dis ease is the presence of fine red lines in the skin. These mark out the course of the in flamed vessels. They may be traced from the place where the irritating substance has been introduced, the neighbourhood of which place is likely swollen, the skin being tight, glazed, and with a deep flush, and their course followed up to the lymphatic gland which the vessels join. Thus, suppose some irritating material, say irritating matter from some bad sore, to have gained entrance at the point of the thumb. After some hours the thumb will begin to feel stiff and painful, and will be evidently swollen and hot. As the inflamma tion develops, the swelling, tenderness, and redness will increase, and the redness will be specially noticed as a sort of broad band down the front of the thumb. This broad red band will be traced over to the wrist, where there is likely to be a specially swollen clump, the meeting-place of several lymphatic vessels. From the wrist bright red streaks will be seen passing upwards to the inner side of the elbow, where there is likely to be a sore spot, and perhaps they pass still upwards to the arm-pit and inflame the glands there. This is the direction the lymphatic vessels take, as may be seen from Fig. 129. The red streaks are hard, and painful when touched. As the in flammation goes on they broaden, till neigh bouring streaks meet, and thus a great extent of the limb, or even the whole of it, may be come swollen and painful. If the inflamma tion be severe, the patient is likely to have chills and shivering fits (rigors), and there are probably fever, sickness, and prostration. It may lead to the formation of matter in the course of the vessels, or may set up inflamma tion in a lymphatic gland, ending in abscess.

The worst result is where the poison passes beyond the gland and sets up blood-poisoning (septicaemia or pyiemia), in which case death may result from the violence of the poison within a few hours. In simple cases the in flammation is expended on the vessels and on the gland, and slowly subsides after attaining its height.

Treatment.—The affected part must be kept at perfect rest. This can be properly managed only by the patient staying in bed. Warm applications are to be kept to the inflamed region. At once a large (lose of saline medicine must be given, such as epsom-salts, seidlitz powders, &c., so that a speedy and copious dis charge from the bowels is obtained. These are the first and simple means to be adopted, and in uncomplicated cases are sufficient. Nevertheless, as one cannot at first judge how serious the case may turn out to be, and as within a few hours an apparently simple case may show evidences of threatening life, a medical man should at once be consulted. If that is not possible, and the fever be considerable, 5-grain doses of quinine every four or six hours should be administered, and the patient should have as a drink 120 grains of chlorate of potash dissolved in a pint of barley-water or lemonade, to be drunk within twenty-four hours. Strengthening food is of the utmost consequence in severe cases. (Refer to BLOOD-POISONING, p. 315.) It is evident that since this disease is usually due to the introduction of poisonous material, great care should be exercised in its prevention. For this purpose, if one has received a wound from an instrument whose cleanness is sus pected, or has a wound--a prick with a sharp instrument, a cut, a scratch, &c.—into which some poisonous stuff has been introduced, the part should be immediately grasped tightly nearer to the heart than the wound, so as to stop the circulation of blood in the part, the lips should be at once applied to the wound, so that it may be sucked vigorously to remove the poison, and as soon as possible a stream of pure water should be run upon it to wash it thoroughly. Not till this has been done should the grasp on the part be released, and by this time probably all injurious material has been removed. If these precautions are promptly and vigorously taken, no further treatment is likely to be necessary, unless covering the wound till it is healed, to prevent the entrance of any irritating substance at a later period.

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