This section is from the book "The London Medical Dictionary", by Bartholomew Parr. Also available from Amazon: London Medical Dictionary.
27. Abscessus ossium. An abscess of the Bones. Observations in practice prove, that not only in the cellular parts near the joints, but also in the middle cavities of the large bones, inflammations have degenerated into abscesses. The observation of Ruysch, in which he says, "that he found, in the middle cavities of the large bones, round bony pipes, separate from the rest of the bones in which he saw them,"may be referred to this article. See Abscessus periostei. 35.
28. Abscessus pa' Lpebrae. An abscess in the Rye-lid, when externally situated, requires no peculiar management different from abscesses in general, except that in opening it, when situated near the cilia, great care is required not to enter the lancet any deeper than is barely necessary to evacuate the abscess; if the edge of the eye-lid is cut, an incurable wateriness is endangered. The direction of the incision is safest in the course of the orbicular muscle. An abscess situated on the inside of the eye-lids may be opened with a lancet, and then washed with brine, or other proper collyria.
29. Abscessus pancreatis. An abscess of the Pancreas. This complaint is the most common in scorbutic habits. Riolan says, that its presence is properly guessed at by a sense of weight in the region of the stomach, no hardness nor tumour being manifest in the hypochondria, particularly if there are other marks of latent obstructions in the abdominal viscera; a difficulty of breathing from the compression of the diaphragm also occurs; and sometimes by pressing near the side of the stomach a tumour is perceptible, and then the pressure causes pain. Though the diagnostics are generally very obscure or uncertain, yet it may be observed that a hectic fever, long watchings, short sleeps followed by a sense of weariness, fainting, and cold sweats, are certain attendants of this disease: Yet the same symptoms attend abscesses, and even infractions of the other viscera; and no peculiar plan of treatment is applicable to the abscess of the pancreas. See Riverius's Prax. Med. lib. xiii. cap. 4.
30. Abscessus parotidis. An abscess of the Parotid Glands, also called Parotis. The parotid glands suppurate with difficulty; the less so when the general habit is disordered, when a venereal, scorbutic, pestilen-tial, or other affection attends. They are apt to become fistulous; though, when they arise in children, unattended by any other disease, there is no danger of ill consequences; and in such circumstances the best remedies are purgatives, mixed with small doses of calomel, frequently repeated. In more advanced life, Trillian lays it down as a rule, that the cure must begin with bleeding: and Celsus, with great judgment, proposes, that, "when the parotis is unattended with any other disorder, the cure may begin with repellents and discutients; but, on the contrary, if any other complaint hath preceded or attends, suppuration must be immediately promoted."the management under suppuration is the same as in other similar cases. viz. the Bubo, q. v. and Kirkland's Med. Surgery, ii 142. In some instances, it begins without any fever, like a swelling of a conglobate gland. It enlarges considerably, suppurates in one minute point; and the whole soon becomes a ragged foul ulcer. A hectic, with considerable emaciation, terminates the complaint. We are seldom aware of its nature soon enough to employ medicine: and from its event this has been styled a malignant parotid.
31. Abscessus pectobis et mammae. An abscess of the Breast. For the former, sec Vomica. The latter is an external disorder, which happens, for the most part, to women. Bruises sometimes are the cause; but, generally, a too active separation of the milk, or taking cold while the woman continues to suckle. Inflammation of the lungs and pleura often produce abscesses in the breast, externally, and upon the ribs, which, in bad constitutions, prove fistulous, and render the bones underneath carious. A frequent cause is from not letting the child suck until two or three days after its birth. An early application of the child to the breast, or otherwise emptying the breasts before they arc turgid with the milk, would in general prevent this complaint. Another cause is the use of astringents, to repel the milk. When an abscess arises from the milk, it is called sparganosis. If these abscesses burst at the top, sinous ulcers are sometimes the consequence; and this happens, too, from laxity in the habit, and a debility in the constitution. When inflammatory tumours happen in the breasts of pregnant women, or of those who are nurses, we ought to be very cautious in the use of repellents; in sanguine habits, bleeding and opening medicines are necessary, with a cooling regimen. If such tumours do not very easily and speedily give way, suppuration should be promoted, for this is the best way of preventing its increase, but the supposed bad consequences have no real foundation, for a cancer is never the consequence of a milk-sore. The common white bread poultice, for neatness and efficacy, equals, if not excels, all other applications, as a suppurant in these cases; it should be applied, and renewed as frequently as is necessary for keeping up an equal warmth, which will be every two or three hours, and continued till the abscess breaks of itself; and then we have only to enlarge the opening a little, if it be too small, or alter its direction if not sufficiently low. A small opening is generally preferable to a large one, as it heals both sooner and more kindly; some advise to make an opening during the state of inflammation, because of the pain which attends these tumours; but by these premature discharges fresh collections will be formed, and thus may the whole breast be wasted. An abscess here should be opened by incision, never by a caustic: only if the lancet passes near the nipple, if possible, it should be directed semicircularly, both to avoid cutting it, or the areola, for thus the beauty of the part is best preserved, and future suckling not prevented. It sometimes happens that, in order to heal a present abscess, or to prevent the formation of new ones, it is absolutely necessary to wean the child, and gradually divert the milk from the breasts. See Bell's Surgery, v. 396. Kirkland's Med. Surgery, ii. 160 - 175. Pearson's Principles of Surgery, i. 73, etc. White's Surgery, 441.