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 Part III: Learning from Other Worlds
Chapter 7. Our Planetary System
This chapter offers an introduction to our solar system, with an emphasis on giving
students a common background in the essential information about the planets that will
allow a deeper look in coming chapters. We begin by imagining an alien spacecraft
coming in from afar and mapping the broad features of the solar system. Then we focus
in on individual worlds, taking a tour of the Sun and the planets. Finally, we discuss
spacecraft exploration of the solar system.
As always, when you prepare to teach this chapter, be sure you are familiar with the
online quizzes, interactive figures and tutorials, assignable homework, and other
resources available on the MasteringAstronomy Web site.
Additional information on recent discoveries in planetary science can be found at
http://dps.aas.org/education/dpsdisc/ in PowerPoint format suitable for classroom
presentation.

Key Changes for the 7th Edition: For those who have used earlier editions of our
textbook, please note the following significant changes in this chapter:
• We have edited and updated throughout the chapter, including changes to some
illustrations, to improve clarity for students and to make it current with the latest
space missions.
• Note that the last page of the solar system tour now focuses more on dwarf planets
in general and less on Pluto in particular.
• This book has gone to press shortly after Curiosity’s landing on Mars, so we have
incorporated discussion and a figure illustrating its landing sequence, which
replaces the similar discussion and figure of Cassini/Huygens in the prior edition.

Teaching Notes (By Section)

Section 7.1 Studying the Solar System
• This section introduces the “big picture” layout of the solar system in figures followed
by our “tour” of the major worlds in the solar system. The Sun and each planet get a
full page, with sizes and distances referenced to the same scale (the 1-to-10-billion
Voyage scale) introduced in Section 1.1. The section includes a useful one-page table
of planetary facts essential for understanding the behavior of planets. This section also
introduces and emphasizes the concept of comparative planetology, the idea that
similarities and differences among the planets can be traced to common physical
processes. This is the unifying theme behind all of Part III and should focus students
on the importance of learning processes over facts.

150 Instructor Guide Copyright © 2014 Pearson Education, Inc.

Section 7.2 Patterns in the Solar System
This section builds upon the first section by summarizing all the features of our solar
system that offer clues to its formation. We focus on four major features that must be
explained by a scientific theory of solar system formation: (1) large bodies have orderly
motions; (2) planets fall into two main categories; (3) many small bodies populate the
solar system; and (4) there are a few exceptions to the rules, such as the tilt of Uranus or
our unusually large Moon (relative to the size of Earth).
• Note that we refer to residents of the Kuiper belt as comets in order to emphasize
their icy compositions; not all planetary scientists refer to these objects in this way.

Section 7.3 Spacecraft Exploration of the Solar System

• This section is designed to give students a brief overview of the use of spacecraft in
planetary exploration.
• Note that we divide robotic spacecraft into four categories: Earth orbiters, flybys,
orbiters (of other worlds), and probes/landers. This helps focus students on the key
differences among the types of missions.
• This section also has a new historical Special Topic on the determination of the
astronomical unit, allowing students to see how Kepler’s relative scale of the
system could be converted to absolute units.

Answers/Discussion Points for Think About It/See It for Yourself

Questions
The Think About It and See It for Yourself questions are not numbered in the book, so
we list them in the order in which they appear, keyed by section number.

Section 7.1
• (p. 191) This question is designed to encourage students to spend some time
exploring the solar system tour. For the specific questions: (1) Students should
notice the composition differences among the planets; (2) The “Earth-like” planets
are the inner four; (3) Students should recognized that the planets naturally group
into two main categories that separate the inner four and outer four planets.

Section 7.3
• (p. 208) No. Because of their differing orbital periods, they no longer have a simple
alignment like they did during the 1980s. In particular, Uranus has caught up with
Neptune by now, so we won’t be able to visit both with a single slingshot from Saturn.
• (p. 209, SIFY) This activity asks students to find planets in the night sky in order to
connect their “book learning” with something they can actually see in the sky. As
instructor, you can really help motivate this activity by bringing it up at the start of
a lecture, mentioning where the planets are and when to look for them. If your
campus has telescopes for public viewing, encourage this activity as well.

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 151
 Solutions to End-of-Chapter Problems (Chapter 7)
Visual Skills Check
1. A = Mercury, B = Mars, C = Venus, D = Earth, E = Neptune, F = Uranus,
G = Saturn, H = Jupiter; Dots to D are the terrestrial planets and E to H are the
jovian planets.
2. The pairs are Mercury and Mars, Venus and Earth, Neptune and Uranus, Saturn
and Jupiter;
3. d
4. a. The exponential plot shows information on low-mass planets that can’t be seen
on the linear plot; b. The linear plot; c. The exponential plot.

Review Questions
1. Comparative planetology is a way of studying the solar system that relies on
comparing the objects in the solar system to each other. The objects do not need to
be planets; moons, rings, asteroids, and comets are all part of the field, for example.
2. If we looked at the solar system with our naked eye from beyond the orbit of
Neptune, we would see points of light for the various planets. The planets would
not appear as much more than bright stars, although if we watched them for a
while, we could see that they orbit the Sun. The four major features providing clues
to solar system formation are (1) planetary motions are mostly orderly: orbits and
rotations are in the same direction and with generally small tilts; (2) there are two
types of planets, jovian and terrestrial, with very different properties and locations;
(3) there are also two classes of “small bodies,” comets and asteroids, also with
distinction properties and locations; (4) despite the “neatness” of the preceding
facts, there are notable exceptions that require explaining.
3. Some possible answers are:

Mercury
• Rotates three times for every two orbits
• Appears to have shrunk early in its life
• The most metal-rich planet
• Has 3-month-long days and nights
• Temperatures varying from extremely hot to extremely cold over the course of
a full solar day
• Has no atmosphere

Venus
• Spins backward compared to its orbit
• Hottest surface temperature of any planet due to its extreme greenhouse effect
• Has a dense atmosphere
• Roughly the same size and mass as Earth

152 Instructor Guide Copyright © 2014 Pearson Education, Inc.

 Earth
• Has a surprisingly large moon
• Only planet with life (as far as we know)
• Only planet with oxygen in the atmosphere

Mars
• Has two tiny moons that might have once been asteroids
• Has volcanoes larger than any on Earth
• Has a canyon that runs one-fifth of the way around the planet
• Has polar ice caps
• Shows signs of once having flowing water
• May have once had life
• Has a thin atmosphere
• Most studied planet apart from Earth

Jupiter
• Largest planet, more than 300 times Earth’s mass and 1000 times Earth’s
volume
• Has no solid surface
• Has dozens of moons and thin rings
• Has three moons that may have subsurface oceans
• Has a moon, Io, that is the most volcanic body in the solar system

Saturn
• Has the most spectacular ring system
• Has many moons
• Has a moon, Titan, that has a dense nitrogen atmosphere

Uranus
• Spins on its side
• Has over a dozen moons
• Looks blue due to methane in its atmosphere
• Has a ring system

Neptune
• Slightly smaller in radius than Uranus, but more massive
• Has rings and many moons
• Has a moon, Triton, which is larger than Pluto and appears to have geysers
• Has a moon, Triton, that is the only large moon to orbit opposite the direction of
its planet

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 153
 Pluto
• Has a semimajor axis larger than Neptune’s, but sometimes comes within
Neptune’s orbit
• The radius of its only moon, Charon, is half that of Pluto’s radius
• Never visited by a spacecraft
• Made of rock and ice, not gas
4. Orderly motions in the solar system are
• Planets all orbit in nearly the same plane and have nearly circular orbits.
• Planets orbit the Sun in the same direction.
• Most planets spin in the same direction as they orbit.
• Most of the large moons in the solar system also orbit in the same sense as the
planets—in nearly circular orbits, generally in nearly the same plane.
5. Terrestrial planets orbit close to the Sun and are tightly spaced together. They are
made mostly of rock and metal and are smaller and denser than jovian planets.
Terrestrial planets tend to have few, if any, moons and none have rings.
In contrast, jovian planets are more distant from the Sun and are separated by much
larger distances. They are made mostly of hydrogen, helium, and hydrogen
compounds. They are much less dense than terrestrial planets. They are also larger
than terrestrial planets. Jovian planets have many moons and have ring systems.
The terrestrial planets are Mercury, Venus, Earth, and Mars. The jovian planets are
Jupiter, Saturn, Uranus, and Neptune. Pluto does not fit into either class.
6. Hydrogen compounds are chemical compounds that use hydrogen and another
common element. The most important hydrogen compounds are water (H 2O),
ammonia (NH3 ), and methane (CH 4 ). Hydrogen compounds are important
ingredients in the jovian planets, Pluto, and comets.
7. Pluto is like a terrestrial planet in that it is small, relatively dense, and solid. It also
includes rock as an important component, a terrestrial planet property. However,
like the jovian planets, hydrogen compounds are also an important ingredient of
Pluto. Furthermore, it has a distant orbit from the Sun like the jovian planets.
Unlike either type of planet, Pluto has an eccentric and inclined orbit and is much
smaller than even the terrestrial planets.
8. Asteroids are rocky or metallic bodies that orbit the Sun, but are much smaller than
the planets. Most asteroids are found between the orbits of Mars and Jupiter in the
“asteroid belt.”
9. Comets are small, icy bodies that orbit the Sun. The difference between comets and
asteroids is composition: While comets are made mostly of ices, asteroids are made
mostly of rock and metals. Also, comets usually spend most or all of their time
much farther from the Sun than asteroids.
10. The Kuiper belt is a disk of comets just past the orbit of Neptune. The Oort cloud is
a spherical cloud of comets that surrounds our solar system much farther from the
Sun. Comets in the Kuiper belt orbit the Sun more or less in the same plane as the
planets and travel around the Sun in the same sense as the planets do. Oort cloud
comets orbit the Sun with tilts of any value and often orbit “backward” relative to
the planets.

154 Instructor Guide Copyright © 2014 Pearson Education, Inc.

11. Exceptions to the rule include:
• Pluto has a high orbital eccentricity and inclination.
• Venus spins backward.
• Uranus and Pluto spin on their sides.
• Triton and many small moons orbit their planets backward.
• Earth’s Moon is huge considering it orbits a terrestrial planet.
12. Flybys are missions that pass by a planet or moon without going into orbit or
landing. Most of the data are therefore taken in a burst of activity when the
spacecraft is close to the planet. The advantage of flybys is that they get to their
targets faster and are cheaper since they can use less fuel and are simpler to plan
and build.
An orbiter goes into orbit around the planet. The main advantage of this is that they
take data for a much longer period of time, often years. Interesting moons or sites
on the planet can be reimaged after they are discovered, unlike with flybys.
Orbiters can also make maps of the planet and its moons with far better resolution
than flybys because they are generally closer to the targets and are able to take their
pictures over longer periods, therefore doing a more careful, detailed job.
Landers or probes descend into the planet’s atmosphere or down to the surface and
land, taking data from up close. While landers are able to examine only much
smaller parts of their planets, they are able to perform types of analyses that are not
possible from a distance, such as determining chemical compositions. The pictures
they return are also much more detailed, giving us a better idea of what the geology
of the surface is like.
Sample return missions gather up bits of their target (whether it’s a planet, a comet,
or something else) and return it to Earth for study by humans in laboratories.
Because laboratories here on Earth are much better equipped to study the nature of
the samples and because humans are more adaptable in our ability to study
something than a robotic spacecraft, samples are considered very valuable.

Does It Make Sense?

13. Pluto orbits the Sun in a direction opposite that of all the other planets. False. Like
other Kuiper Belt objects, it orbits in the same direction as the planets.
14. If Pluto were as large as the planet Mercury, we would classify it as a terrestrial
planet. False. Terrestrial planets are rocky and Kuiper belt objects are icy. Also, it
might still not meet the IUA definition of “clearing its zone.”
15. Comets in the Kuiper belt and Oort cloud have long, beautiful tails that we can see
when we look through telescopes. False. The vast majority of comets lie far from
the Sun, too far to create tails, etc.
16. Our Moon is about the same size as moons of the other terrestrial planets. True,
although there are more moons that are smaller than are larger.
17. The mass of the Sun compared to the mass of all the planets combined is like the
mass of an elephant compared to the mass of a cat. True.
18. On average, Venus is the hottest planet in the solar system—even hotter than
Mercury. True. Mercury is very hot on its dayside, but cool on the night side.

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 155
19. The weather conditions on Mars today are much different than they were in the
distant past. True. Mars was once warmer and wetter.
20. Moons cannot have atmospheres, active volcanoes, or liquid water. False.
21. Saturn is the only planet in the solar system with rings. False—there are many
counterexamples.
22. We could probably learn more about Mars by sending a new spacecraft on a flyby than
by any other method of studying the planet. False. Landers and orbiters are needed.

Quick Quiz
23. b
24. c
25. c
26. b
27. c
28. b
29. a
30. b
31. c
32. c

Process of Science
33. We don’t send probes, landers, or rovers as the first mission to another world for
two reasons. Most importantly, we don’t know in advance what questions we hope
to answer with such a detailed mission—we wouldn’t know what kinds of
instruments to put on the spacecraft. Secondly, we don’t know where to target it on
the surface. Mars offers a good example of how this strategy could have gone
wrong. Much of Mars is heavily cratered with little evidence of the influence of
water we know was once important. If the Mars rovers had landed there, they
would have reported back a much more boring planet. By first mapping the planet
with an orbiter, we knew which regions showed evidence for water, and landed our
rovers there. Furthermore, since we knew from earlier missions that Mars had an
atmosphere, we were able to use that atmosphere to slow down the rover landing
packages.
34. Group Work Exercise (no solution provided)

Short Answer/Essay Questions

35. Many possible answers, based on student interest.
36. Students should coherently summarize the patterns of motion listed as bullets on
page 205, and make the basic observation that these patterns would not have arisen
if every planet had formed from a different cloud at a different time. There would
be no reason for the motions of the planets to be similar. Students will gain a
deeper understanding of the reasons in Chapter 8.

156 Instructor Guide Copyright © 2014 Pearson Education, Inc.

37. a. Planets closest to the Sun are the warmest, as they absorb more solar energy
(per unit area). Venus violates the trend, due to its greenhouse effect.
b. Density: Jovian planets are all less dense than 2 grams per cubic centimeter,
while terrestrial planets are all more than 3 grams per cubic centimeter.
Composition: Jovian planets are all dominated by H, He, and hydrogen
compounds, while terrestrial planets are mostly rocks and metals. Distance:
Jovian planets are all 5 AU and beyond, while terrestrial planets are all inside
2 AU. Pluto’s misfit status is also the subject of Problem 37.
c. The orbital periods increase with the planets’ semimajor axes, according to
Kepler’s third law ( p 2 = a3 ).
38. a. The column “Rotation Period” gives the time for a day—although note that it
is a day relative to the stars (i.e., a sidereal day—see Section S1.1), not the
Sun. For all planets other than Mercury or Venus, the difference is small.
Jovian planets have shorter days than terrestrial planets.
b. Planets with significant axis tilts will have seasons: Earth, Mars, Saturn,
Uranus, Neptune, Pluto.
c. In Appendix E, students should notice that planets with different minimum/
maximum distances (i.e., significant eccentricities) will have temperature
variations due to changing distance from the Sun: Mercury, Mars, and Pluto.

Quantitative Problems
39. Since we are asked “how many,” this problem seems best approached with ratios.
We will take the ratio of the volume of Jupiter to the volume of Earth, which will
give us the number of Earths that could fit inside Jupiter. Our ratio looks like:

4
π r3
volume of Jupiter 3 Jupiter
=
volume of Earth 4 3
π rEarth
3
We can save ourselves a lot of mistakes in calculating these if we use some algebra
and cancel terms in the numerator and the denominator:
3
volume of Jupiter rJupiter
= 3
volume of Earth rEarth

We can also help ourselves by recalling that a n /b n = (a /b) n , making our final
expression:
3
volume of Jupiter ⎛ rJupiter ⎞
=⎜ ⎟
volume of Earth ⎝ rEarth ⎠

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 157
 This final expression is particularly nice because Appendix E tells us that the radius
of Jupiter is 11.19 Earth radii. In other words, rJupiter /rEarth = 11.19. So we can
compute the ratio quite easily now:
volume of Jupiter
= (11.19)3
volume of Earth
= 1400
This tells us that around 1400 Earths could fit inside of Jupiter.
40. Kepler’s third law tells us:

p 2 = a3

where p is the planet’s period in years and a is its semimajor axis in astronomical
units. So we can solve for the semimajor axis by taking the cube root of both sides
of the equation:

a = p 2/3

We are told that Ceres has a period of 2.77 years. So we can calculate the
semimajor axis:

a = (2.77)2/3
= 1.97 AU

So Ceres orbits with a semimajor axis of 1.97 AU. Looking at Table 7.1, we see
that that puts it between the orbits of Mars and Jupiter.
41. We know that density is defined as mass/volume. So we need the mass, which we
are given, and the volume, which we will have to calculate. Luckily, we recall that
the volume of a sphere is given by the expression:

4
volume = π r3
3
But before we calculate anything, we should convert our radius into centimeters
because we want our density to be in grams per cubic centimeter. So we convert,
first to meters then to centimeters:

1000 m 100 cm
12,800 km × × = 1.28 × 109 cm
1 km 1m

Now we calculate the volume:

4
volume = π (1.28 × 109 cm)3
3
= 8.78 × 1027 cm3

158 Instructor Guide Copyright © 2014 Pearson Education, Inc.

 As mentioned earlier, we want our final number to be in grams per cubic
centimeter. So we had better convert our mass into grams before finding the
density. This is easily done:
1000 g
5.97 × 1025 kg × = 5.97 × 1028 g
1 kg

So finally, we find the density using the definition:

mass
density =
volume
5.97 × 1028 g
=
8.78 × 1027 cm3
= 6.80 g/cm3

Therefore, the density of the planet is 6.80 grams per cubic centimeter. Such a large
density means that this is almost certainly a terrestrial planet.
42. The first and most obvious trend is that the more massive planets all have higher
escape speeds than the less massive planets. This is not unexpected since escape
speed increases with mass. (It decreases with rising radius, but the masses seem to
jump up faster than the radii do, so the mass wins.) Particularly interesting are
Jupiter and Saturn, which have almost the same radius but are quite different in
mass. Jupiter’s escape speed is much higher, almost twice as large as Saturn’s. This
makes sense for the more massive planet.
Also interesting are Uranus and Neptune. Neptune is somewhat more massive than
Uranus and has a slightly smaller radius. Both of these factors tend to increase the
escape speed. Neptune’s escape speed is higher than Uranus’s, so that makes sense.
43. In Chapter 5, we learned that the expression for weight is:
weight = mass × (surface gravity)

We’re told that our weight here on Earth is 100 pounds. So we can solve for our
mass:
100 lb
mass =
Earth's surface gravity

(Usually, we’d convert into metric units, but this time we won’t need to.) So we
can plug this into the expression for weight to find that:

planet's surface gravity

weight = (100 lb) ×
Earth's surface gravity

(Note that the units of surface gravity cancel out. So we are OK leaving the weight
in pounds this time.)

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 159
 Now, this is convenient. In Appendix E, we are given the planet’s surface gravity in
Earth units. So all we have to do for each planet is multiply 100 pounds by the
surface gravity that we are given, and we have the weight. So computing:

Planet Surface Gravity Weight

Mercury 0.38 38
Venus 0.91 91
Earth 1 100
Mars 0.38 38
Jupiter 2.53 253
Saturn 1.07 107
Uranus 0.91 91
Neptune 1.14 114
Pluto 0.07 7

44. We will assume that the spacecraft travels in a straight line and that it goes from
Earth’s average distance from the Sun to Pluto’s average distance on the shortest
path possible. So the distance it travels is:
aPluto − aEarth
where the as are the semimajor axes of the two orbits. We know that Earth’s
semimajor axis is 1 AU and Appendix E tells us that Pluto’s is 39.5 AU. So the
distance traveled will be 39.5 AU – 1 AU = 38.5 AU.
We are told that the spacecraft will take 9 years to get to Pluto. So, recalling that
speed is distance divided by time, we can find the speed:
distance
speed =
time
38.5 AU
=
9 yr
= 4.3 AU/yr
We are also asked to find this speed in km/hr, so we need to convert:
1.496 × 108 km 1 yr 1 day
4.3 AU / yr × × × = 73,000 km/hr
1 AU 365.25 days 24 hr

The spacecraft will travel an average speed of 4.3 AU/yr or 73,000 kilometers per
hour.
45. To find the distance to Venus, we use the figure in “Special Topic: How Did We
Learn the Distance to the Planets?” This figure suggests that the parallax we
measure on Earth is the angular size of Earth as seen from Venus. Recall that in
Mathematical Insight 2.1 we learned that distance, angular size, and physical size
are related by the expression:
angular size physical size
=
360° 2π × distance

160 Instructor Guide Copyright © 2014 Pearson Education, Inc.

 We can solve this for distance:
360° × (physical size)
distance =
2π × (angular size)
We know the physical size (diameter) of Earth, because the radius is
6378 kilometers: It is just twice the radius, or 12,756 kilometers. We know the
angular size of Earth (as seen from Venus), but we need to convert it to degrees.
We are given that the parallax is 62.8″, so we convert to degrees:
1' 1°
62.8" × × = 1.74 × 10−2 degrees
60" 60'
So we calculate the distance from Venus to Earth:
360° × (12,756 km)
distance =
2π × (1.74 × 10−2 degrees )
= 4.20 × 107 km
So the distance should be about 4.2 × 107 kilometers. We can convert this to the
more useful unit of astronomical units:
1 AU
4.2 × 107 km × = 0.28 AU
1.496 × 108 km
which corresponds to the difference between Earth’s and Venus’s semimajor axes.

Copyright © 2014 Pearson Education, Inc. The Cosmic Perspective, Seventh Edition 161
Another random document with
no related content on Scribd:
previously resistant; and, third, a suppurative infection, as above
described.
In contradistinction to these distinct events, separated by an
appreciable, sometimes a considerable, length of time, we recognize
a mixed infection, where two or more organisms are implanted at or
about the same time. An illustration of this is seen in most cases of
gonorrhea in which there is a synchronous attack made by the
gonococcus, which is a specific microörganism, accompanied by
staphylococci or streptococci, whose effect will complicate the case
and make it assume a less particulate type of infection. Mixed
infections may often occur in other ways, as syphilis and chancroid,
chancroid and gonorrhea, etc. Most cases of mixed infection belong
rather to surgery than to general medicine, and constitute an
apparent violation of the rule to which physicians often point—that
two distinct infectious diseases are seldom communicated or
acquired at the same time. Nevertheless, the facts remain as above.
Terminal Infections.—Terminal infections constitute an apparent
paradox, perhaps oftener in medical than in
surgical cases. Few people, as Osler has shown, die of the diseases
from which they suffer. The final exitus is due to a more or less rapid
infection which terminates life. These terminal infections are mainly
due to a few well-known microbes, such as the streptococcus,
staphylococcus aureus, pneumococcus, bacillus proteus,
gonococcus, bacillus pyocyaneus, and the gas bacillus. In surgery
such infections are, perhaps, most often seen in malignant
lymphoma, diabetes, tuberculosis, syphilis, cancer, and in the so-
called surgical kidney.

BACTERIA OF PUS FORMATION.

Bacteria which act as agents in the formation of pus are
collectively known as pyogenic organisms. These are divided into
two groups:
A. The Obligate; and
B. The Facultative.
Obligate pyogenic organisms are those whose activity is
manifested in the direction of pus formation, which seem to produce
it if they produce any unpleasant action whatever. On the other hand,
the facultative organisms are those which are known occasionally to
be active in this direction, and yet which are not always nor
necessarily so. The members of group A are fairly well known and
catalogued, and are not numerous. On the other hand, there is
reason to believe that many organisms may have the occasional
effect of producing pus, as it were, by accident or at least in a way
not absolutely natural or peculiar to themselves, but still are
frequently found when there is no pus present. A suitable list of the
facultative organisms, therefore, can hardly be made, and will not be
here attempted, the effort being only to mention the more common
organisms which play this facultative role. It may be mentioned also
that even the adjectives “obligate” and “facultative” are to be
accepted with some mental reservation, since staphylococci, for
instance, may be met with even in the absence of pus, although
nearly all that we know about these organisms implies that pus
would be the result of their presence. Furthermore, there are certain
other organisms, not, strictly speaking, bacteria, which also have the
power of producing either pus or pyoid material. These also will be
mentioned in their place. Some of them belong not only to the
vegetable, but also to the animal kingdom.
Obligate Pyogenic Organisms.—One of the characteristics of
A. The Staphylococcus Pyogenes Aureus, Albus, Citreus, the
Staphylococcus Epidermidis, etc.
the staphylococci as a group is the powerful peptonizing action
which they exert. Moreover, the chemical products of their life
changes seem to be more potent in a local than a general way,
leading to greater destruction of tissue in their immediate vicinity,
with greater inhibition of the chemotactic powers of the leukocytes;
that is, with more interference with phagocytosis, by which their
progress would be interfered with. Their presence is recognized by a
peculiar odor, as of sour paste, which should lead to a prompt
change of dressings and disinfection of the wound (by irrigation,
spraying with hydrogen dioxide, etc.).
B. Streptococcus Pyogenes and Streptococcus Erysipelatis.—These two
organisms do not differ in morphology nor characteristics, and, while
for some time considered as distinct from each other, are now by
most observers regarded as identical. The streptococci grow in
chains of variable length, and individual cocci vary in size. They grow
with and without oxygen, in all media, at ordinary temperatures, do
not liquefy gelatin, stain readily, sometimes but not invariably
coagulate milk, and vary in longevity. They differ extraordinarily in
virulence according to their sources.

Fig. 4 Fig. 5

Staphylococci in pus. × 1000. (Fränkel Streptococci in pus. × 1000. (Fränkel

and Pfeiffer.) and Pfeiffer.)

There are many streptococci not included under the above head
which are indistinguishable morphologically and in other respects,
and yet which are partly or entirely free from pathogenic activity in
man. A biological study reveals remarkable and unexplainable
transformation between the different members of this species, a part
of which may be referable to conditions pertaining to the organisms
infected, but part of which apparently pertains to the bacteria. It is
held by some that scarlatina is an invasion by certain organisms of
this class; this, however, is not yet definitely established. When
found in the stools of children with summer diarrheas they are
regarded as indicating ulceration of the intestinal mucosa.
In contradistinction to the staphylococci, the streptococci manifest
a predilection for lymph vessels and lymph spaces, along which they
extend with great rapidity. They have less peptonizing power than
the staphylococci (except in the absence of oxygen); hence
streptococcus infection assumes usually the type of widespread
infiltration rather than of circumscribed and distinct edema. One sees
remarkable instances of this in cases of phlegmonous erysipelas. It
is suggested also that the peculiar manner of growth of the
streptococci, in long chains which may coil up and entangle blood
corpuscles, has much to do with the formation of fat emboli and with
pyemic disturbances.
Both these bacterial forms have the power of producing lactic
fermentation in milk; and lactic-acid formation sometimes takes place
with suppuration in the human tissues, causing acidity of discharge,
sour odor, and watery pus. It appears also that these two pyogenic
forms have less power of ptomain or toxin formation than many
others, and, consequently, that the pyrexia attending suppuration or
purulent infiltration is not always to be ascribed to this cause alone,
for fever may in some measure be due to tissue metabolism
attending their growth, the metabolic products being pyretic. This is
in a measure substantiated by the fever attending trichinosis, where
the question of ptomain poisoning has not yet been raised.
C. Micrococcus Lanceolatus.—Micrococcus lanceolatus is also known
as the diplococcus pneumoniæ or the pneumococcus of Fränkel and
Weichselbaum, and as the micrococcus of sputum septicemia of
Pasteur and of Sternberg. It is of interest to surgeons because it
causes many localized inflammations and is a frequent factor in
causing septicemia; it is often present in the mouths of healthy
individuals. It may produce the various forms of exudates as the
result of congestion set up by its presence; also otitis media,
meningitis, osteomyelitis, and suppurative disturbance in the
periosteum, the salivary glands, the thyroid, the kidney, the
endocardium, etc.
 Fig. 6

Diplococcus pneumoniæ of Fränkel. (Karg and Schmorl.)

D. The Micrococcus Tetragenus.—Suppurations produced by these

organisms are prolonged, mild in character, not painful, but
accompanied by much brawny induration of tissues.
E. The Micrococcus Gonorrhœæ.—The micrococcus gonorrhœæ, or
gonococcus, is found constantly in the pus of true gonorrhea, in
many cases the pus being a pure culture of this organism. These
cocci are generally seen in pairs (biscuit-shaped), while their
inclusion within the leukocytes or their attachment in or to epithelial
cells is characteristic. Unlike other pyogenic cocci, they do not stain
by Gram’s method, being decolorized by iodine, by which fact they
may be distinguished. They are cultivated with difficulty, and are
known rather by their clinical effects than by their laboratory
characteristics; are human parasites, other animals, so far as known,
being practically immune. The gonococcus may also produce
abscesses, and may be carried to distant parts of the body, where its
effects are commonly noted as pyarthrosis, although endocarditis,
pericarditis, pleurisy, etc., are known to be due to it, and fatal pyemia
has been produced in consequence. In some way it is probably the
explanation of the post gonorrheal arthritis, wrongly spoken of as
gonorrheal rheumatism.
F. The Bacillus Coli Communis or Colon Bacillus.—This is an inhabitant
of the intestinal canal; varies extremely in virulence and somewhat in
morphological appearances; coagulates milk; is often associated
with other organisms; migrates easily both along the alimentary
canal and from it into the surrounding tissues or channels. It is a
disturbing element in the production of kidney and hepatic disease,
also in the production of appendicitis and peritonitis. Ordinarily its
pyogenic properties are not virulent; occasionally, however, it
becomes extremely virulent.
G. The Bacillus Pyocyaneus.—The bacillus pyocyaneus, a widely
distributed organism, often observed in the skin and outside of the
body; a motile, liquefying bacillus, growing at ordinary temperatures,
seldom seen alone, but occasionally producing pus without
association with other organisms; it stains the discharges and
dressings a bluish-green and imparts sometimes an offensive odor.
Suppuration caused by this bacillus is usually prolonged, but
characterized by little constitutional disturbance.
Facultative Pyogenic Organisms—i. e., those which have the
power of provoking
suppuration, but which have other and more distinct pathogenic
activities as well.
A. Bacillus Typhi Abdominalis.—This is found in many pus foci,
developing during or after typhoid fever. It is occasionally met with
alone, though most of these abscesses are really mixed infections. It
is generally found in the bone or beneath the periosteum. Such
abscesses are frequently seen in the ribs, and may not be noticed
until months after convalescence from the fever. The pus contained
within them is not always typical in appearance, but may be unduly
thin or unduly thick.
B. Bacillus Proteus.—Under this name are included three distinct
forms, which were originally described by Hauser as distinct species,
but which are now regarded as pleomorphic forms of the same
organism. It is a motile bacillus, met with in decomposing animal and
vegetable material, and occasionally found in the alimentary canal. It
has been known to produce pus, especially in the peritoneal cavity
and about the appendix. It may even cause general infection and
peritonitis.
C. Bacillus Diphtheriæ.—A non-motile bacillus, varying considerably
in size and shape, changing the reaction in sweet bouillon from acid
to alkaline; produces a dangerous infective inflammation of exposed
surfaces, with tenacious exudate amounting to a distinct membrane.
As a part of its life history it also produces a toxalbumin, which is one
of the most powerful cell poisons known, the disintegration of the cell
constituents due to its action being rapid and pronounced. This
accounts for the heart failures which are often reported in connection
with the disease.
D. Bacillus Tetani.—More will be said about this organism when
considering tetanus, and to that subject the reader is referred. The
tetanus bacillus is occasionally found in pus which comes from the
area through which the original infection was produced. But these
bacilli do not travel to any distance in the human body, and are
seldom found away from the area involved. Under most
circumstances the pus is the product of a mixed infection.
E. Bacillus Œdematis Maligni.—This organism will be more fully
considered under a different heading. (See Malignant Edema.) It is a
long, anaërobic bacillus, widely distributed in the soil and the feces
of animals. It is believed that this, like the tetanus bacillus, may
occasionally lead to formation of pus.
F. Bacillus Tuberculosis.—This organism likewise will receive fuller
description in an ensuing chapter. (See Tuberculosis.) The pus of old
cold abscesses in which the more obligate pyogenic organisms have
long since died usually contains this organism in mildly virulent form.
On the other hand, fresh suppurations occurring in connection with
tuberculous disease are mixed infections. There is reason to believe,
however, that this organism is capable of producing pus even when
none of these are present; for example, in that form of acute miliary
tuberculosis which is occasionally met with as bone abscess it may
be found.
G. Bacillus Anthracis.—This is one of the most malignant and
resistant organisms known, being in the highest degree poisonous
for the smaller animals, man being less susceptible. One of its
characteristic lesions in the human body is a form of pustule
commonly known as malignant pustule, the pus in which is usually a
pure culture of this organism. (See Anthrax.)
H. Bacillus Mallei.—This is the organism which produces glanders in
the lower animals and in man. That form of the disease known as
farcy, in which the infected nodules rapidly break down, is likely to
contain pus which will be more or less a pure culture of this
organism.
I. Bacillus Lepræ.—This is the microörganism which produces
leprosy, closely resembling the tubercle bacillus. It is constantly and
exclusively present in the lesions of leprosy, which are often of the
suppurative type, the bacilli being enclosed within pus cells; it is also
found in the fluid surrounding them. Although suppuration in these
cases may be in a large measure due to secondary infection, it is
positive that the leprous bacilli deserve to be grouped in this place.
J. The Bacillus Pneumoniæ of Friedlander.—The bacillus pneumoniæ
of Friedländer was at one time regarded as the cause of croupous
pneumonia, which is now known to be due to the micrococcus
lanceolatus. The Friedländer bacillus, however, is capable of
producing bronchopneumonia, and is occasionally met with in
empyema, suppurative meningitis, and inflammations about the
nasopharyngeal cavity, of which it is known to be an occasional
inhabitant.
K. The Bacillus of Rhinoscleroma.—A distinctive organism has been
described for this disease and given this name. It has such wide
morphological differences, however, that it is possible that it is only
the bacillus of Friedländer above mentioned. At all events, an
organism of this general character is constantly found in this disease
in the thickened tissues from the nose (Fig. 8).
L. The Bacillus of Bubonic Plague.—This was recently discovered by
Kitasato, and, in view of the recent ravages of the disease in the
Orient, has assumed considerable importance. It grows upon most
media, and is found in the blood, in buboes, and in all internal organs
of patients suffering from this disease. The smaller animals are
susceptible upon inoculation. Animals fed with inoculated foods die
also, showing the possibility of infection through the intestine. When
exposed to direct sunlight for a few hours the bacillus dies. The
general symptoms of the disease are those of hemorrhagic
septicemia and its consequences.
M. The Bacillus of Rauschbrand.—This is seldom, if ever, seen in this
country. It is known in England as “the black-leg” or “quarter-evil.” It
is an anaërobic organism, frequently met with in cattle, which causes
a peculiar emphysema of subcutaneous tissue, spreads deeply, and
is followed by a copious exudate of dark serum with gas formation.
The smaller animals are not ordinarily inoculable; but if to the culture
material there is added 20 per cent. of lactic acid, their
insusceptibility is overcome and they succumb to the disease. So,
also, as in the case of the tetanus bacillus, by addition of the bacillus
prodigiosus or of proteus vulgaris the disease may be produced in
otherwise insusceptible animals.
N. The Bacillus Aerogenes Capsulatus.—The bacillus aërogenes
capsulatus seems capable sometimes of causing pyogenic and even
fatal infection. Its presence is associated with gas formation. It grows
as an anaërobe.
O. The Bacillus of Chancroid.—The bacillus of chancroid identified by
Ducrey, and briefly described in the chapter on that subject.
 Fig. 7 Fig. 8

Rhinoscleroma: infiltration of tissues Bacilli of rhinoscleroma. × 1000.

about the nose. (Case reported by Dr. (Fränkel and Pfeiffer.)
Wende, Buffalo.)

YEASTS.
Busse was the first to call attention of clinicians and pathologists to
the role played by yeasts in certain infections. Since the original
observations of Busse in a case in which the organism produced a
general infection, the lesions of which were a combination of tumor
and abscess formation, various observers have noted the presence
of pathogenic yeasts, usually in skin lesions. Gilchrist and Stokes
were the first in this country to determine the nature of these
organisms, and their observations have been followed by the
detection of a large number of similar cases. In the skin lesions the
organisms are found in minute abscesses; in the subcutaneous
tissue and in the infections similar to those of Busse large abscesses
surrounded by extensive masses of granulation tissue characterize
the infection. The organisms can be detected in the pus by means of
an examination of the fresh unstained fluid (Fig. 9).
 FUNGI.
Besides the micro-organisms everywhere grouped as bacteria,
there are other minute organisms which have also the power of
engendering pus. One of these is the ray fungus, known as the
actinomycis, which causes the disease known as lumpy jaw or
actinomycosis. Suppuration is always a concomitant of the advanced
lesions of this disease, and, while it may be in many instances a
mixed infection, it is not necessarily so. Moreover, the pus produced
under these circumstances contains minute calcareous particles
which are pathognomonic, by which a diagnosis can sometimes be
made off-hand.
Besides these fungi, others, belonging rather to the class of
vegetable molds, which are yet pathogenic for human beings, may
be occasionally met with under these circumstances—e. g., the
fungus of Madura foot, the leptothrix, and other molds from the
mouth, while the different varieties of aspergillus may be found in
pus about the ear or even in that from the brain.

PROTOZOA.
The protozoa have the power of producing, if not absolute ideal
pus, something so nearly resembling it that we may include them
among the facultative pyogenic organisms. The best known of these
protozoa are the amebæ, which are met with in the intestinal canal in
some countries, occasionally in the United States, especially as the
exciting causes of a peculiar type of dysentery often accompanied by
abscess of the liver. In these abscesses the amebæ are found, and
no other organisms. Another group of the protozoa, known to
biologists as the coccidia, are also capable of causing pus formation,
more particularly in some of the lower animals. Numerous other
parasites, belonging higher in the animal kingdom, are undoubted
exciters of pus formation, though it is not necessary to lengthen the
list beyond those already mentioned.
 Fig. 9

Blastomycetic pus (fresh). × 1000. (Gaylord.)

Protozoa have recently been established as the active agents in

the production of smallpox and probably also of scarlatina. They
have been seen so generally in and around cancer cells as to make
it extremely probable that cancer is a protozoan infection. In syphilis
also they are found as the spirochetæ, now regarded as its cause.
 Protozoa are as ubiquitous as bacteria, but their recognition is as
yet more difficult, as but little is known of them. The numerous
stages through which they pass in completing their life cycles only
complicate the subject, while the difficulties encountered in
cultivating them are still to be overcome. As we become more
familiar with them we shall more frequently find them to be
pathogenic organisms.

CLINICAL CHARACTERISTICS OF PUS FROM DIFFERENT

AGENCIES.
Staphylococcus.—Dirty white, moderately thick, with sour-paste
odor.
Streptococcus.—Thin, white, often with shreds of tissue.
Colon Bacillus.—Thick, brownish, with fetid odor, or thin, dirty
white, with thicker masses.
Micrococcus Lanceolatus.—Thin, watery, greenish, often copious.
Bacillus Pyocyaneus.—Distinctly green or blue in tint.
Bacillus Tuberculosis.—Thick, curdy, white paste, or thin, greenish,
with small, cheesy lumps or even with bone spicules.
Actinomycis.—Thick, brownish white, with small, firm, gritty or
chalky nodules of yellow color.
Ameba Coli.—Thick, brownish red.

BACTERIAL DETERMINATION AS AN INDICATION IN

TREATMENT.
There is a practical side of great importance pertaining to the
recognition of the nature of the infectious organism in many cases of
suppuration and abscess. For instance, pus which is due to
streptococcus invasion indicates a collection which should be freely
evacuated and carefully drained. This is also true in essential
respects of staphylococcus pus, particularly that due to the
streptococcus aureus. Putrid pus from any source requires
disinfection and free drainage, the former preferably perhaps by
hydrogen dioxide. Pus which is due to the colon bacillus is not often
extremely virulent, which accounts for so many cases of appendicitis
recovering with or without operation. A collection of this pus needs
little more than mere drainage and opportunity for escape. Pus from
a recognizable tuberculous source may still contain living tubercle
bacilli. This means either that the cavity whence it came should be
completely destroyed and eradicated, or else that the margins of the
incision or opening through which it has escaped should be so
cauterized that infection of a fresh surface is impossible. The same
is true of abscesses due to glanders bacilli and to certain cases of
suppurating bubo following chancroid, where the whole course of
events shows the virulent character of the organisms at fault.

SUPPURATION.
Although it may be possible to produce in certain laboratory
experiments metamorphosed material which very closely simulates
pus, or, in fact, by injection of chemical irritants, to sometimes imitate
the suppurative processes, nevertheless, the student should be
brought face to face with the statement, to which for surgical
purposes there is no practical exception, that suppuration, i. e.,
formation of pus, is due to the presence in the tissues of the specific
irritants already catalogued and described, and of the peculiar
peptonizing or other biochemical changes which bacteria exert upon
living animal cells.
Coagulation Necrosis.—Coagulation necrosis is the term applied
to the characteristic changes occurring in
the tissue cells when thus attacked, which may be summarized as a
fading away of cell outlines, diminution in reaction to reagents, and a
merging of cells and intercellular substance. Coagulation necrosis is
not the only result of bacterial activity, but may be produced by other
causes. Nevertheless, pyogenic bacteria do not exert their
deleterious action upon the tissues without occasioning changes
included under this term. In an area thus infected, as already
described, leukocytes, i. e., phagocytes, are present in increased
number for purposes already mentioned. As we approach the centre
of activity phagocytes are more numerous than cells, and
intercellular barriers completely break down. When bacteria are
found in greatest number, there also occurs the greatest phagocytic
activity, and there also will be found the evidence of suppuration,
i. e., pus. As already indicated, the polynuclear leukocytes are most
active in the process of defence. Where coagulation necrosis is most
marked there has been the greatest activity of conflict with the
greatest death of cells. Around these areas bacteria and cells are
found in indiscriminate arrangement. Tissue vitality is impaired by
intoxication of the cells by the excretory products of the bacteria,
i. e., the so-called ptomains, toxins, etc., and their power of
resistance is thus weakened. From the mechanical results of
pressure tension around the centre of activity is increased, by which
tension vitality is still more impaired and more rapid tissue death
occurs. Thus there occurs migration or burrowing of pus; or, to state
it more clearly, the tissues break down in front of the advancing
destruction, and in the direction of least resistance. This is known as
the pointing of pus, which brings it many times to the surface, and
often in other and less desirable directions.
Abscess.—An abscess is a circumscribed collection of pus. The
term is used in contradistinction to purulent infiltration, in
which the collection is not circumscribed, but is exceedingly diffuse
and extends itself in various directions, the amount at any spot being
almost inappreciable. Purulent infiltration is regarded as the more
serious of the two conditions, as it is more difficult for pus to escape
under these circumstances than when it can be evacuated through a
single opening. The term phlegmon is one now generally used to
indicate a suppurative process, usually of the general character of
purulent infiltration rather than of abrupt abscess, but generally
employed to include both conditions. The adjective phlegmonous is
coupled with the names of other surgical infectious diseases to
indicate that it is complicated by suppuration, e. g., phlegmonous
erysipelas. Pus is a product of bacterial activity usually formed
rapidly rather than otherwise, and abscess formation or
phlegmonous activity of any kind is a question of but a few days.
Empyema means a collection of pus in a preëxisting cavity.
The significance of this condition is well described in the story of
inflammation and suppuration, to paraphrase Sutton, read
zoölogically, as though it were the story of a battle: The leukocytes
(phagocytes) are the defending army, the vessels its lines of
communication, the leukocytes being, in effect, the standing army
maintained by every composite organism. When this body is invaded
by bacteria or other irritants, information of the invasion is
telegraphed by means of the vasomotor nerves, and leukocytes are
pushed to the front, reinforcements being rapidly furnished, so that
the standing army of white corpuscles may be increased to thirty or
forty times the normal standard. In this conflict cells die, and often
are eaten by their companions. Frequently the slaughter is so great
that the tissues become burdened by the dead bodies of the soldiers
in the form of pus, the activity of the cells being proved by the fact
that their protoplasm often contains bacilli in various stages of
destruction. These dead cells, like the corpses of soldiers who fall in
battle, later become hurtful to the organism which, during their lives,
it was their duty to protect, for they are fertile sources of septicemia
and pyemia. This illustration may seem romantic, but is warranted by
the facts.
Around the margin of the site of an acute abscess a barrier is
formed by condensation and cell infiltration of the surrounding
tissues. This is not a distinct wall nor membrane, yet, nevertheless,
serves as a sanitary cordon to confine the mimic conflict within
reasonable bounds. This is the zone of real inflammation; within it
there are tissue destruction and coagulation necrosis. By virtue of
the peptonizing power of the pyogenic organisms the parts involved
in this necrosis gradually liquefy the intercellular substance
dissolving first. It is this which in the main forms the fluid portion of
the pus. Various tissues show widely differing resistance to this
softening process. In true glands the interlobular septa seem to
break down first, and in this way suppuration extends around the
acini or gland lobules, and thus pus may contain masses of easily
recognizable size. These masses are ordinarily known as sloughs.
It is by virtue of the so-called lymphoid cells, which are those
principally involved in producing the barrier or boundary of the acute
abscess as above described, that granulation tissue is formed, which
takes up the effort of repair as soon as pus is evacuated. This
boundary has no sharp limit, but shades off into healthy surrounding
tissues.
 Under the term “abscess” is meant that which is described as
acute abscess. Under certain circumstances, especially when they
are produced by the facultative pyogenic organisms rather than the
obligate, abscesses form more slowly, and may be spoken of as
subacute. These are terms used in contradistinction to the so-called
cold abscesses, which, although clinically bearing a certain
resemblance to the acute, are in almost every pathological respect
different from it. Cold abscesses will be considered under the head
of Tuberculosis. It is possible to have an acute pyogenic infection of
a cold abscess; in such case we have acute manifestations.
Gravitation abscesses are those where pus forming in one part tends
to migrate, usually in the direction in which gravity would take it,
extending into portions deeper or lower. Perhaps the best illustration
of this is the pointing of a psoas abscess below Poupart’s ligament.
Metastatic abscesses are those which are formed as the result of
embolic processes, each one being in miniature a repetition of a
lesion which has occurred at some other part of the body. The
underlying fact concerning metastatic abscesses is that the primary
process has occurred in some other portion of the body, whence it
has been distributed as above. These will be considered in the
chapter treating of Pyemia.
The product of all acute suppurative lesions is pus. This is an
opaque fluid of creamy consistence and whitish or grayish
appearance, varying in density, met with in amounts from a minute
drop to half a gallon or more. Under ordinary circumstances it is
odorless, and its reaction, either acid or alkaline, is very faint. It is,
like the blood, composed of a fluid and a solid portion. The solid
portion consists of so-called pus corpuscles and other debris of
tissue, which vary with the site of the disease and the parts involved.
The source of the pus corpuscles has been cited and the statement
made that they are in effect the bodies of phagocytes which have
perished in the biochemical fight for existence of the parent
organism. Cocci or bacilli are found in pus corpuscles and also in the
surrounding fluid.
Pus should be without odor, but under certain circumstances it
possesses an odor which will vary in character according to the
source of the pus or the nature of its principal bacterial excitant. Pus
from the upper end of the alimentary canal frequently has the sour
smell of gastric contents; that from the neighborhood of the lower
end, the fetid odor which is for the most part due to the action of the
colon bacillus. Inasmuch as colon bacilli are found in widely distant
parts of the body, they may also give an unpleasant odor to pus even
from a brain abscess. When the pus has become contaminated with
the ordinary saprophytic organisms, it may smell like any other
decomposing material. The older writers called it ichorous pus, while
sanious pus was supposed to be that more or less mixed with blood,
undergoing ammoniacal decomposition or else strongly acid. Pus
sometimes has a well-marked blue or bluish-green tint. This is due to
the presence of the bacillus pyocyaneus, already described. An
orange tint is sometimes given by the presence of hematoidin
crystals, due to the original hemorrhagic character of the infected
exudate. The former appearance indicates usually a slow course to
the suppurative lesion, while the latter has been regarded by some
as affording an unfavorable prognosis. Distinctly red pus, whose tint
is due to the presence of a bacillus giving bright-red cultures on
blood serum, has been noted in other instances. This can readily be
distinguished from blood, because upon dressings it does not
change color.
Pus may form superficially, when it is called subcutaneous
suppuration, in which case there is a minimum of pain, because
tension is not great and the distance to the surface is short.
Collections which form beneath the fasciæ, especially the deeper
fasciæ of the limbs and trunk, give rise to much more extensive
disturbance, both locally and generally, and frequently do not point
for many days; or, instead of pointing, burrow deeply and find their
outlet at some undesirable point. These are known as subfascial
collections. Subperiosteal abscesses give rise to still more pain,
because of the unyielding character of their limiting structures, and
the symptoms caused by them are acute and distressing.
An illustration of the pain which may follow deep suppuration may
also be seen in the ordinary panaritium, or bone felon, where the
path of infection is from without, but the destructive lesion is confined
within absolutely unyielding tissues, at least at first. Along certain
tissues infection spreads with rapidity. This is particularly true of the
delicate areolar tissue seen between tendons and tendon sheaths,
and the infectious process may follow this tissue wherever it shall
lead, even along complex courses.
The question often arises, Can pus be resorbed? There is no
question but that small amounts of pus are disposed of by
phagocytic activity, and the disappearance of purulent infiltration,
under the influence of favoring remedies, or even when let alone, is
not infrequently noted. True pus resorption is a question of
phagocytic possibilities, and can occur only in very limited degree, as
a result upon which it is not safe to count, and which is capable of
encouragement only up to a certain point.
One inevitable law seems to govern collections of pus, that when
they advance or migrate in any direction it is in that of least
resistance. This causes them to take peculiar and sometimes
disastrous courses, but it is a law which is never violated. It leads to
the bursting of abscesses into the brain, into the pleural cavity, into
the peritoneal cavity, the bowel, and elsewhere; it leads to a
condition where pus may travel along a path even a foot or more in
length, rather than come to the surface, a distance of perhaps an
inch, and affords one of the best reasons for early operative
interference so that the disastrous effects of burrowing may be
obviated. When the pus is limited to a drop or fraction thereof the
abscess is called a furuncle, especially when in the skin. The
average “boil” of the layman is a subcutaneous or subfascial
abscess. When the infiltration is pronounced, and when there has
been more or less extensive destruction of tissue, with perhaps
formation of numerous outlets for the escape of pus and detritus, it is
known as a carbuncle. (See Chapter XXVI.) In certain conditions
small superficial furuncles or boils form, sometimes in great number
and almost synchronously, or, as it were, in crops. This condition is
known as general furunculosis.
Signs and Symptoms of Abscesses.—The appearances by which pus
may be suspected or detected are those of congestion and
hyperemia, more or less abruptly circumscribed and markedly
accentuated. Along with these there is more or less edema or
edematous infiltration of the skin and overlying tissue, which permits
of that peculiar appearance known as “pitting on pressure.” Often,
too, there is a distinctly edematous swelling of the parts, especially
around the margin, with brawny infiltration of the centre of the
infected area. Numerous vesicles occasionally are noted upon the
skin, which may be filled with reddish serum. When softening and
pus formation occur, there is a condition which to the palpating
fingers gives the characteristic sensation known as fluctuation.
Fluctuation simply points out the presence of fluid beneath; but when
in an area marked as thus described fluctuation is noted, it means
the presence of pus. It is detected by manipulating in a direction
parallel to and concentric with the axis of the limb or part. The pain is
also in most instances significant; patients speak of it as having an
intense and throbbing character. With these local signs occur
symptoms indicating some degree of septic intoxication, i. e.,
pyrexia, chills, malaise, sweats, etc., which are corroborative
indications, their intensity being a reasonably correct index of the
severity and gravity of the local infection.
When a deep-seated abscess is suspected a careful blood count
will often permit a diagnosis to be made. This is conspicuously true
of cases of appendicitis. If leukocytosis is established there should
be immediate operation. (See Chapter II.)
It is seldom that a superficial collection of pus can be mistaken for
anything else. In small and superficial abscesses (boils, furuncles)
as pus approaches the superficial layer (epidermis) of the skin it may
be discovered through its thin covering. In deep lesions there is often
a doubt, even on the part of the most experienced. The measure
now usually resorted to for purposes of diagnosis and exact
recognition is the exploring or aspirating needle. The old exploring
needle was one of good size, having a groove along which, after
introduction, pus might pass. Since the almost universal use of the
hypodermic syringe, a small aspirating needle attached to the
ordinary syringe is the measure commonly adopted. Such a needle
may be introduced into the brain, into the liver, or into almost any
and every soft tissue without danger, and if properly manipulated is
almost sure to facilitate detection of pus. Exploration done with either
of these means and for this purpose should always be conducted as
an aseptic, even if a minor operation, in order that no extra infection