Blue bell (Polemonium reptans) also known as Abscess Root, American Greek Valerian, False Jacob's Ladder and Sweatroot is a plant of the family Polemoniaceae. It grows in damp woods by creeping roots. The stem is about five centimetres long, much branched and bearing pinnate leaves with six or seven pairs of leaflets. The flowers are nodding, blue in colour and hang in loose terminal bunches. A tincture of the root is used in medicine as an expectorant. Research Blue Bell
An abscess is any collection of purulent matter or pus formed in some tissue or organ of the body, and confined within some circumscribed area, of varying size, but always painful and often dangerous. Research Abscess
Amebiasis is a protozoan parasitic infection caused by the ameba Entamoeba histolytica, which lives in the large intestine of humans as part of the residentflora. Humans contract the infection is acquired by ingesting food or water contaminated with faeces. It occurs most often in poor countries where the standards of public hygiene and sanitation are low. Once ingested, the incubation period varies from a few days to several months. In rare cases, the symptoms may not appear for years. Entamoeba histolytica competes with the host for food in the large intestine. It multiples by simple division. Protective cysts develop and the organism is passed out with faeces. The cysts can survive long periods before the next host acquires them. Some strains of the ameba are harmless and the people carrying them show no symptoms. Other strains invade the intestinal wall causing bleeding and mucus secretion and diarrhoea. Ulcers are formed in the intestinal wall where the ameba gain access to the bloodstream and move to the liver and/or brain. Symptoms of severe amebiasis include persistent moderate to severe diarrhoea, jaundice, abdominal discomfort and in severe cases the development of an abscess in the liver or in the brain. Research Amebiasis
Appendicitis is a disease which became well-known during the 19th century. It consists in inflammation of the vermiformappendix of the large intestine, a somewhat wormlike hollow body, several inches long, projecting from and opening into the intestine, but closed at the opposite extremity. In appendicitis proper the inflammation begins in the appendix and spreads to neighbouring parts, and thus the disease is sometimes included under the term perityphlitis, which more strictly belongs to inflammation connected with the caecum, and not necessarily with the appendix.
Appendicitis is usually set up by more or less hard bodies that become lodged in the appendix, especially particles of food that have not been sufficiently masticated. The disease may be very slight, lasting for a day or two, and accompanied with some pain and sickness; or it may take a severe and violent form, the result being death in a few hours. Death may also occur at a longer interval, when an abscess forms, which bursts into the abdominal cavity. There are also cases of chronic and of relapsing appendicitis, and in these removal of the organ is necessary. Some surgeons resort to removal of the appendix in all cases of the disease. The usual symptoms are such as pain in the belly, especially low down on the right side, fever, constipation, nausea, and vomiting. Early remedies were such as rest in bed, hot fomentations or poultices applied to the belly, with opium to relieve pain, food being given in small quantities, in the fluid form and hot. During the 20th century surgery became the preferred treatment, the appendix being cut out by a surgeon. Research Appendicitis
Empyema thoracis is the condition of pusformation in the pleural space. The pleural effusion which accompanies infective conditions of the lung may itself become infected and form pus. A lung abscess may burst into the pleural space. Haemothorax may become infected. The symptoms which the condition produces depend on the amount of puspresent, and the degree of compression of, or disease in, the underlying lungs. There is some embarrassment of respiration, and 'swinging' fever, typically present whenever pus has accumulated in the body. Fever may sometimes be absent, especially if the patient is being treated with antibiotics. The patient with an empyema is severely toxic, looks ill, loses weight rapidly and becomes severely anaemic. If the pus is sufficiently thin to be removed through a needle, then the treatment is entirely by aspiration. Penicillin or other antibiotic solution may be injected into the pleural space after the withdrawal of the pus. Aspiration needs to be repeated daily until lung expansion is adequate. If the pus becomes too
thick for aspiration, the empyema is treated by one of two surgical methods: (a) A small intercostal incision is made and a large self- retaining catheter placed into the pleural space to allow the escape of pus. The catheter is connected to an under-water seal. This method of intercostal drainage is rarely used but it is sometimes suitable for children. (b) Rib resection and drainage by a wide-bore tube. Part of one rib is removed and the pleural space opened through its periosteum. This tube may be left open at its outer end or may be attached to an under-water seal. One type of tube is the 'Tudor- Edward' empyema tube which has an additional small rubber side tube through which the empyema cavity can be irrigated. Research Empyema Thoracis
Pleural effusion is used to indicate the accumulation of any fluid within the pleural space. An effusion is described as 'clear' 'blood-stained' or 'turbid' according to its appearance when it has been aspirated. It may occur from inflammation of the pleura, especially in tuberculosis; the quantity of fluid may be so great that a lung is completely compressed and the hemi-thorax is filled with fluid right up to the clavicle. Pleural effusion may occur in heart failure or be produced from inflammation below the diaphragm in such conditions as subphrenic abscess, liverabscess, perinephric abscess or cholecystitis. The presence of a pleural effusion is detected by clinical examination of the chest and its extent is demonstrated by x-ray. Apart from thoracic surgery, pleural effusion may occur in surgical patients as the result of post-operative pneumonia or more commonly from the inflammation produced by small infarcts in the lung. These infarcts themselves have arisen from pulmonary embolism. The presence of a pleural effusion is common if there is malignant disease in the thorax, either a primary carcinoma of the lung or secondary deposits from some other organ such as the breast or the stomach. It is not uncommon for such effusions, secondary to malignant disease, to need repeated aspiration. Research Pleural Effusion
The rectum is the lowest portion of the large intestine, terminating at the anus. The rectum is S- shaped, about 22 cm long, and is formed of muscle layers similar to those elsewhere in the intestinal tract. The lower end of the rectum is funnel-shaped and terminates in the analcanal which is lined with a special form of skin. The rectum is 'slung' in the bottom of the pelvis between the levator animuscles. Below this level and around the analcanal is a strong sphincter of voluntary muscle - the external sphincter. The internal sphincter is the thickened lower end of the involuntary rectal muscle. Stretching or weakness of the levator ani muscle, or nervous conditions causing paralysis of this or the external sphincter allow the rectum to drop. The lining mucousmembrane is then 'prolapsed'. On either side of the analcanal below the levator ani muscle is a space containing fat - the ischio-rectal fossa. This is sometimes the seat of infection and abscessformation.
The analcanal has arteries and veins from the systemic circulation coming from the perineum and buttocks. The arteries join with the branches of the inferior mesenteric artery while the veins join with the tributaries of the portalvein which drain the rectum. If the portal veins are blocked or compressed (as in extreme constipation or in more serious disorders which affect the liver, such as cirrhosis) the haemorrhoidal veins become dilated or 'varicose'. These varicosities around and inside the analcanal immediately underneath the lining membrane are called ' piles' or haemorrhoids. Sometimes during strain at stool the veins are temporarily distended and one of them bursts, producing either brisk haemorrhage or a perianal haematoma (a form of external ' pile'). The rectum is normally empty except immediately before defaecation. The passage of the faecal mass from the colon into the rectum produces the desire to evacuate. If the rectum is insensitive, no such desire occurs, and extreme constipation arises. Research Rectum
When any portion of body tissue has been destroyed by disease or violence, the adjacent tissues at once set to work to repair the gap. Clearly their task will depend on the extent of the gap and the presence of any factors which hinder normal tissue activity. When a clean surgical incision has been made and the edges sewn closely together the gap to be bridged is very thin. On the other hand, if there has been an abscess and a large area of tissue has been dissolved away, the problem is very much greater. There are many factors which infuence the rate of the body's power of healing. Where a gap has been left in the tissues, the 'raw' surfaces are covered with blood clot and any intervening cavity may in fact be filled with blood. From the ends of the capillaries which have been cut on either side, cells grow rapidly into this haematoma (a collecion of blood in the tissues) and form granulation tissue, which is thus a mass of tiny little capillary buds with fibrous tissue cells.
As the days go by, the very rich blood supply enables fibrous tissue to grow rapidly and become more dense, and finally to cement the gap. Weeks later the blood vessels die off and firm fibrous tissue (scartissue) remains. This becomes slowly tighter and tighter. This process we know as contraction, so that what may appear to be quite a large scar shrinks down over a period of months to become sometimes invisible. Perhaps the best example of this is the cavity left by the removal of the slough from a large carbuncle; in a very few months there is a small white, irregular scar marking the centre of the great cavity where the carbuncle existed. If the wound has involved other tissues than connective tissue - for instance, the mucousmembrane of the cheek, or the skin - then the very specialised epithelial lining also grows across as a sheet of cells and covers up the granulation tissue. The same process occurs in the intestinal tract; when an anastomosis (artificial opening between two hollow organs or vessels) has been performed, the cut edges of the mucousmembrane are stuck together temporarily by fibrin, and over a period of days the cells lining the stomach or intestine grow rapidly across the gap. When a bone is broken, repair takes place in a similar way: calcium substances from the blood are deposited in the granulation tissue forming callus. Into this callus the specialised cells which form true bone, migrate from the surrounding damaged bone: over a period of weeks or even months the minute structure is rebuilt to join up exactly with the bone on either side of the break.
The healing power of the body is influenced by many factors. An adequate supply of oxygen is necessary for these tissue repairs, and as oxygen is carried to the tissues by the blood, anaemia results in a very poor healing rate. Vitamins, especially vitamin C, are necessary for the repair of tissues, so that patients whose reserve of vitamin C has been depleted heal more slowly and may in fact not heal at all. Patients who are ill use more vitamin C than the normal healthy individuals and sometimes, unless their requirement is met, a wound may come apart even a week or more after operation, showing no sign of healing whatever. Infection always delays healing as it interferes with the activities of the cells at the edges of the wound. Similarly, if the patient' s general health has been impaired by longstanding disease or bad nourishment his powers of healing are poor, as the substances required for the repair are in short supply. The presence of foreign bodies or a poor blood supply (such as occurs in arteriosclerosis, or if the stitches have been tied too tight) will also delay sound healing. In addition, there are many personal and undetermined factors which must be responsible for the fact that some people heal quickly and others heal very poorly. Age is important; babies and children repair their tissues very much more rapidly than old people. This is because the growing child has much more vitality in all his cells. For example, a fracture of the humerus in a new-born baby may be soundly united in ten days; in an adult the same fracture requires about eight weeks to heal. Research Tissue Repair and Replacement
The Probert Encyclopaedia was designed, edited and programed by
Matt and Leela Probert
Abbreviations
Research Abscess
