Surgery, Its Principles And Practice 1

Cover Surgery, Its Principles And Practice 1
Surgery, Its Principles And Practice 1
Da Costa, J. Chalmers (John Chalmers), 1863-1933
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A tap that exhibits sterile fluid is an indication but not a proof of the tuberculous nature of the process. If the fluid contains pus-germs, it does not, however, prove the non-tuberculous nature of the process; because one may be dealing with a tuberculous process that has undergone secondary pyogenic infec- tion.
In tuberculous pleurisy it is not advisable to aspirate eariy but aspir- ation should be performed if the effusion displaces the heart considerably and distinctly increases the dysp
...nea. If secondary infection occurs and the effusion becomes purulent, a portion of a rib should be resected and a drainage-tube inserted.
Tuberculosis of the Pericardium.— This condition may be pri- mary, but it is usually secondary to pleural tuberculosis. Autopsies upon patients dead of phthisis show that about one out of every hundred exhibits tuberculous pericarditis. There is a miliary form of pericardial tuberculosis, and a form in which both pericardial layers are enormously thickened and in which caseous degeneration takes place.


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