Suppuration and accumulation of matter

The word “suppuration” in the language of doctors occurs in two meanings. In the first of them, it is applied to any place and means the accumulation of pus by a tumor, and in the second it is used in a special sense for chest disease and by it is meant the filling of the space between the chest and lungs with pus that has broken into it, either on both sides at once, or on one side . The cause of this filling is either catarrh, in which the matter is poured out at once, or ulcers in the lungs, from which ichor and pus gradually flow out, so that the lungs suppurate for the most part after twenty days, and then the pus is coughed up, or the opening of a tumor in the chest area, this only happens more often. The matter is either mature pus or something like wine grounds. In this case, four outcomes are possible: either the matter suffocates with its abundance in order to ultimately kill, this is evident from the fact that the patient’s breathing becomes more and more constrained and he does not cough up mucus, or the lung rots and this drives consumption, or it is cleared by constant slight expectoration, or it is cleared due to the rush of matter through the large vein and large artery to the bladder, appearing in the form of thick urine. The matter goes first from the vein to the liver and then to the kidneys, or passes into the intestines in the form of feces. In both cases this is good.

We have already discussed the timing of opening the tumor. This is determined by the strength of the characteristics, as well as depending on age, time of year and nature. Old people die from suppuration in the lungs more often than young men, due to the weakening of the side where the heart is located, and young men die more often from pain than old men, due to their great sensitivity.

We mentioned signs of suppuration in the section on signs of transition of pleurisy to other diseases, and also talked about signs of tumor opening. As for the signs of filling the chest cavity with pus, these signs are heaviness and a dry cough with shortness of breath and pain. Many such patients sometimes have a wet cough, which brings apparent relief after expectoration. Their breathing is accelerated and their speech is therefore fast, and the muscles of the nose move when breathing, squeezing the nostrils. Such patients are not left with a desiccating fever leading to dropsy. As for the indications on which side the pus is located, this is recognized as follows: the patient lies down first on one side, then on the other; the side over which the oppressive weight hangs is opposite to the place where the pus is located. This is also recognized by the noise of pus, its gurgling and splashing, or in this way; wrap the chest and sides with linen rags, smeared with red clay soaked in water, and see where they dry first; this will be the place where the pus is located.

Signs of successful opening of the tumor are as follows: after opening, the fever calms down and appetite rises, and it becomes easier to cough up and breathe, or after opening, abscesses appear on the side and in adjacent places, forming fistulas, as well as abscesses that cauterize or pierce and pure white matter comes out from there . And an indication of an unfavorable autopsy is the appearance of signs of suffocation, fainting, bad sputum or consumption. If you cauterize or puncture a malignant abscess, a muddy, foul-smelling substance comes out of it. The following signs distinguish pus from mucus in phlegm:   pus in phlegm settles in water and produces a stench when thrown on fire, but mucus floats on water and does not stink. But pus is sometimes released and not during consumption, as we explained in another, previous place. Sometimes those suffering from suppuration cough up a lot of pus. I saw a man who coughed up about two mannas of pus in one hour, counting small mannas, or more than one and a half large mannas, and Galen testifies that a patient with suppuration in the lungs sometimes spews out about fifty mannas of pus every day, that is, almost nine / stooped. You already know the difference between pus and other liquids: pus is recognized by the fact that it produces a stench when coughed up and if it is thrown on fire, and it also settles in water and does not float up.

As for the signs of the transition of suppuration of the lungs to consumption, these are a leaden complexion, a feeling of tension in the sides and neck, constant heat in all fingers, even in those people whose limbs usually become cold during fever, fever that worsens at night, after eating , bulging of the nails due to the fact that the meat under them is melting, oiliness of the eyeball, which turns slightly white and yellow, as well as other signs that we will talk about in the paragraph on consumption.