A B S 



A B S 



nifies 4, was fubflitutcd for 1, or 200. If the lad of tliefe 

 fupjxiiitioiis bo admitted, the 4 IhekL-lri, by Jofeplius's 

 eftimate, would be equal to a quarter of a pound, and by 

 Cumberland's valuation 2 ounces. The learned Bochart in 

 an elaborate differtation on this fubjeft, (apud Oper. toiii. i. 

 p. 883, &c. ed. Villem.) reduces the weight of Abfah-ni's 

 hair to about 2 pounds, which, coniidering the various 

 circumilances mentioned by him, is by no means in- 

 credible. 



AESCEDENTIA, in Surgery, denote morbid parts 

 ■which are in a ftate of feparation. See Abcede. 



ABSCHARON, in Geography, a peninfula adjoininn- 

 tbe Cafpian Sea, and abounding vvitii numerous and pro- 

 tludive fources of naphta and petroleum, and with ialt 

 lakes. On this peninfula is Ctuatcd the city called Baku. 



ABSCESS, in Surgery, from abfcedo, to fiparate, or 

 abs and cerlo, to retire; a cavity containinsr pus, or a 

 colleftion of puriform matter ; called Jl^fcejfiis by the 

 Latins, and 'A7rcV>i//.a by the Greeks. The term Em pvr ma 

 is ufed to defignate thofe Imposthumes which form in 

 parts not contiguous to the integuments of the body, 

 efpecially large Suppurations within the chefl or 

 belly ; and it is fomctimes applied to coUeftions of pus 

 "in the ikuU, the orbits of the eyes, the maxillaiy finuffes, 

 tiie joints, &c. AbfcefTes likewife obtain other denomi- 

 nations, according to their feat ; as Panaris, in the finger ; 

 Anch vLOPs, in the greater angle of the eye ; Hypopyon, 

 in the anterior chamber of the eye ; Vomica, in the paren- 

 chymatous fubftance of the lungs ; Bubo, in the arm-pit or 

 groin; Parotis, behind the ear; Parulis, in the gums, 

 &c. &c. Thefe appellations are explained in their refpeflive 

 places. We fhall now proceed to the general doftrine and 

 treatment of fuppurations ; after which, will follow fome 

 remarks on abfceiies of particular parts, requiring peculiar 

 management. 



The proximate caufe and formation 0/" Abscesses. 



This morbid ftate is always preceded by an inflammation 

 of the veffels from whence the pus has iffued. If the puru- 

 lent matter be well formed, there has been a previous in- 

 creafe of artei-ial aftion, a throbbing in the parts adjacent, 

 an exquifite degree of fenfibility, augmented animal heat, 

 diftenfion of the minute blood vefTels, elafticity of the muf- 

 cular fibres, and an efFufion of fenim, or of coagulable 

 lymph from the arteries immediately affefted. Thefe phx- 

 nomena are followed by a gradual diminution of the pain, 

 heat, rednefs, tenfion, and throbbing, with a dcpofition of 

 puriform fluid into the furrounding cellular membrane. 



Aftual fuppuration having now taken place ; if the pus 

 lies near the furface of the body, a cream-like whitenefs 

 will foon be perceived in fome particular point, near the 

 middle, or towards the inferior fide of the abfcefs : an eleva- 

 tion or prominence next occurs, and a fluftuation may be 

 felt underneath, which becomes more diftinft as the matter 

 approaches the furface ; the pain alfo is confiderably abated, 

 the brilliant appearance of the (Icin declines ; and, if th? 

 collection of matter be large, there is ufually an attack oi 

 ftiivering, accompanied with febrile fymptoras, &c. 

 The general Seat it/" Abscesses. 



In general, if not always, the matter of an abfcefs is pri- 

 marily depofited in the cellular membrane, which furrounds 

 or lies contiguous to the inflamed veffels ; except when the 

 fecreting arteries tei-minate and empty themfelves in a na- 

 tural cavity ; for example, in the thcrax or abdomen. As 

 the te>Uure of the cellular fubllance admits of eafy diften- 

 fion, the pus gradually diffufes itfelf, and forms an exten- 

 five refei-voir, which either ruptures fpontaneoufly, in a 



part affording the lead rcfiftance, or is evacuated by an artf- 

 (iL-ial opening. When pus is confined by a limi adhjfion, or 

 by an a])oneurofis, or is fituattd very deeply among parts 

 that rcfift its preflure, one or more intcrllices will be fomc- 

 times formed of confiderable extent ; the aperture of which 

 may be at a diftancc from the original feat of the dileafe ; 

 and if t!ic matter fliould exill in a vci-y large quantity, the 

 gravitating force of t!ie fluid will give it a tendency to fome 

 depending fpot. Thus it happens, that matter foimed un- 

 der the temporal m.iifcle may be difcharged into tiie mouth, 

 or pus accumulating in the loins may defeend to the lower 

 part of the thigh. We arc, therefore, not to imagine the 

 point where the pus makes it appearance by a protrufion ex- 

 ternally, to be always tlie focus or centre of the ■■.Lfcefs ; al- 

 though it is generally the moft proper place for its evacua- 

 tion. Some judicious remarks on this fubjcdt, by the late 

 Dr. W. Hunter, are contained in \\\& Medical Obfervationt 

 and Enquiriet, vol. ii. p. 57, &c. 



General Indications in the Treatment o/" Abscesses. 



When a praftitioner has afccrtained, from the preceding 

 and concomitant fymptoms, that an abfcefs cxifts, (for this 

 dil'eafe has fometimes been confounded with an hernia or 

 aneurifm,) he (hould carefully detennme whether or not 

 the confined pus ought to be evacuated, and what interme- 

 diate fteps fhould be purfued. It may be a queftlon, in 

 fome cafes, if the fuppuration be complete, or fulUciently 

 advanced for an operation. In other cafes it may happen, 

 that the tumor ought not to be opened, though the matura- 

 tion be pcrfeft. At other times the matter, from its fituation, 

 ought to be evacuated fpeedily, left it fliould injure the 

 contiguous parts. Regard mull alfo be had to the general 

 ftate of the patient's health, efpecially if the fuppuration 

 under which he labours be extenfive, and has arilcn fpon- 

 taneoufly. In cafes of this kind, which occur after a fever, 

 it will be indifpenfably neceflary to adminifter fuch medicines 

 as are adapted to the nature of the internal coinplalnt, as 

 well as to employ appropriate topical remedies to the abfcefs. 

 When it has been determined to open the tumor, the fur- 

 geon fhould confider in what manner this may be beft ac- 

 complifhed, whether by the fcalpel, the cauftic, or the 

 feton ; whether by a fingle opening, or feveral ; by dif- 

 charging the pus at once, or at different times. 



The various Methods of opening Abscesses, 



I. The ancients, and efpecially Albucafis, ufed to open 

 abfceffes by the application of an aftual cautery. 

 But the unneccflary and temfic apparatus of hot-irons 

 being now laid afide, all the advantages of exciting a fur- 

 ther degree of inflammation, &c. previoufly to evacuating 

 the pus, may be obtained by milder remedies. When an 

 abfcefs is feated in a glandular pait, and has been very 

 tardy in advancing to a ftate of maturation, (as is parti- 

 cularly the cafe with fcrofnlous and venereal tumors,) it will 

 be often better to open them with a cauftic than by any other 

 means. The chief grounds of preference in favour of the 

 cauftic are, that it tends to augment the inflammation and 

 fuppuration ; it diminiflies the fubjacent glandular fwelling; 

 it gives free vent to the confined m.atter ; it promotes 

 healthy granulations ; it is mucli lefs likely to be followed 

 by troublefomc finuffes, or by a fore with loofe and callous 

 edges, than when a fimple punfture or incifion has been 

 had recourfe to ; and it may be employed with patients who 

 have an infurmountable dread of the knife. An unfcemly 

 fear is, hov/ever, a not unfrequent confequence of the 

 cauftic ; and on this account, it is not fo eligible in the face 

 or neck, where a cicatrix ought, if pofiible, to be avoided. 

 The method of preparing and applying cauftic fubftariccs, in 



H 3 this 



