Acute and Chronic, Superficial and Deep-Seated.
An abscess is an accumulation of pus at some particular spot, the pus being formed by the degeneration of tissue the result of congestion. Abscess may be caused by obstructions to the circulation, injury, irritation from foreign bodies or the absorption of poison, as in dissection work.
Acute Abscess.
Symptoms. — The formation of an abscess is preceded by pain, inflammation, redness, heat and swelling and in deep-seated abscess there may be general fever — the temperature perhaps reaching 104°[1]. The swelling, hard at first, gradually softens before destruction commences. The brighter the redness the smaller will be the abscess, and the softer the feeling and the darker the appearance the more extensive will be the destruction of tissue. When pus begins to form there is usually a pronounced chill and a local throbbing, with increasing and constant pain. The pus always endeavors to get to the surface, causing elevation and a point to be raised which eventually ulcerates and bursts, allowing the pus to be naturally discharged. The deeper seated the abscess the longer will it be in "coming to a head," and the more liable is the pus to become poisonous. Thick yellow pus is termed "healthy," and after it is discharged healing is usually rapid. Thin, greenish or watery pus is always bad, indicating prostration and difficulty in after healing.
Treatment. — If there is much fever, sweating should be induced by the use of diffusive drinks, such as ginger and sage or pleurisy root tea. In large abscess where the surface is dark, composition (see formulas) should be used freely. Poultices of ground flax seed, sprinkled over with lobelia and golden seal will hasten pus toward the surface. After an abscess is opened dressing of poultices are usually sufficient. Keep the wound open by gentle pressure occasionally[2], and if there is a tendency to degeneration, shown by a dark look of the part, compound tincture of myrrh should be used freely around the opening, and when the pus is poisonous, the tincture diluted can be injected into the wound by a small syringe. Deep seated or extensive abscesses should be opened with a thin and sharp pointed surgical knife as soon as pus forms, taking great care to avoid injuring blood vessels and important structures.
Chronic Abscess.
When the system is in an unhealthy condition during an ordinary abscess, a chronic abscess may result. Scrofulous persons are liable to be such sufferers. Decay of a bone, or of a small particle of bone broken off by fracture may likewise cause chronic abscess. The duration of such a trouble is very protracted, possibly continuing for years. When caused by bone decay there is usually considerable pain, and when there is an involvement of the nerve, spasms are liable to occur. Chronic abscesses may burrow into important structures and cause death, or decomposition of pus may cause fatal trouble, preceded by hectic fever, septicaemia, etc.
Treatment. — Ascertain the cause and remove it if possible. Pieces of decayed bone should be extracted. If there is a tendency to septicaemia, composition should be used freely, and the compound tincture of myrrh externally and internally. Do not open such abscesses prematurely. Let the diet be plain but nourishing, and keep the bowels open and the habits regular and temperate.
Abscesses in Special Localities.
An abscess may form in any organ as a result of injury or disease or obstructions to free circulation. The brain, stomach, liver, kidneys, spleen, bowels and lungs are especially liable to abscesses, and descriptions of these difficulties and their treatment are given in the articles upon diseases of those organs. Faecal abscess is mentioned under Appendicitis, and strumous abscess in the article on Scrofula.
[1] 104° Farhrenheit is equivalent to 40° Celsius.
[2] Conventional wisdom instead suggests that closing an abscess after draining improves healing.