Savannah morning news. [volume] (Savannah) 1868-1887, 1881-08-23
PRESIDENT GARFIELD'S NEW
TROUBLE.
What tne Celebrated German Sci
enlist. DIR. VirchOv, says of Acute
Inflammation of the Parotfd
Gland.

To Rudolph Virchow, Of Berlin, one of
the greatest scientists Of our century, a man
whose influence is felt in almost every de-
partment of medical science, is also due the
best information on the disease which at
this moment attracts special attention on
account of the Presidents case. AS early
as 1858 Virchow wrote in the "Annals of the
Charlie Hospital" an article on this subject,
which is based entirely on his own personal
investigations at the bedside, in the dissect-
ing room and in the laboratory. An abstract
Of the most important points of this paper
will be of interest:
sEPTICEMIA OR PYEMIA.
He speaks very briefly OF the innocuous
form of the disease familiarly known as
mumps, and treats exclusively of the grave
form which supervenes in the course of
grave diseases, such as pneumonia. puerpe-
raj fever, typhus, measles or glanders. He
refers to another treatise of his ("Gesam-
mette Abhandlungen zur Wisseuehaftlichen
Medicin," pp. 4S0, 640), in which he has
shown that the phenomena belonging to So
called py9mia may be classed under two
heads, one class comprising the phenomena
due to embolism-i. E the transportation of
solid corpuscle from one part of the
body to another where It Is arrested in
narrow blood vessel, and q second
class due to infection-that is to say, the
absorption into the blood of a poisonous
liquid. This latter 1t is which he calls sep
tic3mia. The Inflammation Of the paroiis
belongs commonly to this latter class. Its
origin may be understood If it is supposed
that some irritant Is secreted from the blood
with the saliva and produces an irritation of
no CIIrfaPnG VII wi an In
exactly as cantharadin, the irritant agent
in blister, when 1t is absorbed by the blood
and secreted with the urine, irritates the
urinary organs, producing catarrhal or
croupous Inflammation.
QUESTIONABLE BENEFIT OF THE ABsCEss.
The Inflammation of the parotis may be
divided into three groups--the primary,
simple catarrh or mumps, which is usually
epidemic, and has no tendency to suppura-
tiop; the secondary, purulent catarrh,
which readily forms assesses, and Is asso-
ciated with cstarrh of the mouth, sprue,
etc, or sometimes with affections of middle
ear; and, finally, the specific, septic@mic
catarrh, which almost always gives rise to
sanious pus, and is very frequently COM
bined with other so-called metastases-that
Is to say, appearances in other localities,
| either OF a septic8mic or an embolic
character. Ancient writers have laid
formation of an abscess with laudable pus
In the parotis. This is only true in so far as
opposed to cases In which the suppuration
produces thin, sanious pus. It. may be that
the suppuration has a certain favorable
effect on the body, but it is certain that 1t
is much preferable, If 1t can be avoided, for
the Inflammation of the parotis is both in
the beginning and in the end a disorder
which renders the case more complicated
DANGERS OF sUPPURATIvE INFLAMMATION.
The dangers of a suppurative infiamma-
tion OF the parotfd gland are very numer-
Gus. II 1t complIcates the later stages of
other diseases the new disturbance suffices
often to lead to the death Of the exhausted
patients by renewal or increase of the
fever. If the swelling of the surrounding
parts be very considerable the Inflammation
OF the parotis, by impeding the circulation
in the numerous veins which lie in contact
with 1t, may give rise to edema of the tenn
poral region and around the eye, headache,
difficult breathing, etc. These phenomena
become still more violent IL the impediment
to circulation is large enough to cause
coagulation of the blood In the veins
The clots thus formed become so much
more dangerous as they extend far beyond
the gland, and later when they soften be-
come the starting point of embolism and
infection. In severer cases the surrounding
connective tissue is also innamed, and then
the Inflammation extends gradually over the
neighboring parts, causing abscesses in the
muscles, Inflammation OF the auditory ca
nal, periOstitis of the lower 1awbone and
temporal bone, followed by necrosis.
Through the bones the Inflammation NAV
extend to the membranes surrounding the
brain or attack this organ itself.
FOLLOWING THE NERVE COURSES.
Another way in which the Inflammation
spreads is by following the course OF the
nerves. The veins are apt to become OBJ
structed, and clots extend down along the
side of the neck or into the interior of the
cranial cavity. In such cases the inhamma-
tion Of the parotis may, In its turn, become
the starting point of new blood poisoning
and of embolism in the lungs and other
organs. The dangers connected with the
Inflammation Of the parotis are partly due
to the situation Of the organ under dense
fascia or tendinous membrane. This cir
cumstance is also of importance in regard
to treatment. II suppuration cannot be
avoided, it should be fastened, and the pus
emptied as soon as possible. To attain this
end, 1t is often necessary to make deep in
cisions, the swelling of the superficial parts
being so great that pus is reached only at a
depth of half an inch.