Anonymous
Published: 2013-09
Total Pages: 188
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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1899 edition. Excerpt: ...percentage of cases, are not due directly to the operative procedure, but to apparently accessory circumstances during the after-treatment. Among the endonasal operations proper, the galvanocautery is much more frequently associated with complications than cutting operations. By means of" distant action" the protective arrangement in the nose is more readily rendered insufficient. According to B. Fraenkel an angina following endonasal operation is not unfrequently propagated through the lymph channels. However, in some cases, palpation of the naso-pharynx has been the cause of the sub ' sequent angina, and in others, an extensive reactive inflam mation might have followed the endonasal operation, which produces interstices in the epithelium by the increase of emigrating leucocytes from the tonsil, thus furnishing an entrance for the microbes upon the surface of the tonsils. Against the latter view stands B. Fraenkel's doubt of the small etiological importance, for the development of infections, of these interstices in the epithelium, with their current of leucocytes directed outward. Fraenkel's hypothesis is supported by the comparative frequency of angina as sequel to operations, and by the rareness of complication in regions, the relations of which with the lymph channels of the nose are more exactly known, as, e. g., in the meninges. _Moreover, at other places of the lymphatic ring with the same opportunities for the entrance of microbes, such infections are just as rare as swellings of the deeper cervical glands which partly derive their supply from the nasal cavity. The connection with the endonasal operation is left beyond doubt if it is immediately followed by embolic processes. Metastatic suppurations after...