Laudable pus

donna

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Laudable pus is a term used by 19th century doctors to describe the pus that formed in a wound after surgery or amputation, thought to be a beneficial sign of healing. In actuality, of course, it was a sign of massive bacterial infection, which often proved fatal.

From: "Everyday Life During The Civil War", by Michael J. Varhola. page 183.
 
Hard to imagine that they would think that the horrible stench of rotting flesh was a beneficial sign of healing, isn't it? A visit to a Civil War hospital, to check on a wounded comrade, would no doubt send many staggering away, gagging. And yet, the doctors and nurses had to suppress their nausea, and work in that environment, every day.
 
Hard to imagine that they would think that the horrible stench of rotting flesh was a beneficial sign of healing, isn't it? A visit to a Civil War hospital, to check on a wounded comrade, would no doubt send many staggering away, gagging. And yet, the doctors and nurses had to suppress their nausea, and work in that environment, every day.
As a nurse myself, I imagine the doctors and nurses were accustomed to such conditions. Having a strong stomach pretty much goes with the job.
 
If I remember right, the reasoning behind laudible pus being good was that a wound was healing from the inside out. A weeping wound (pus) was actually considered to be cleansing itself. The absense of pus meant (at least at the time) a wound was healing from the outside in and thereby trapping the infection within the body. It was a logical thought process I reckon.
 
If I remember right, the reasoning behind laudible pus being good was that a wound was healing from the inside out. A weeping wound (pus) was actually considered to be cleansing itself. The absense of pus meant (at least at the time) a wound was healing from the outside in and thereby trapping the infection within the body. It was a logical thought process I reckon.
Given the unsanitary conditions and limited medical knowledge of the times, it is amazing the mortality rate was not higher.
 
Don't know if they did it much in the 1860's but bleeding a patient was pretty common in the 1700's and earlier. There's a lot of speculation that it's what killed George Washington, he was pretty much bled to death by his physician in an effort to cure him
 
In book, "The Language of the Civil War" by John D. Wright, the author describes knife used by surgeons for bloodletting.

"Fleam, a small surgical knife or a type of lancer also called a "bleeder". It was used by surgeons for bloodletting, which was still a common practice during the war. Fleams were often spring activated." page 115.
 
Many a soldier survived, sometimes for years, as long as his wound continued to suppurate. But, once the wound healed over and stopped draining, it might continue to drain internally, and blood-poisoning and death would shortly fallow. I have one soldier wounded in May 1864, whose wound continued to drain for almost 35 years, causing him great suffering. It finally healed early in 1899, and he was dead within four days.

jno
 
Imagine you’re in gym class. You and your friend are running the 100-meter dash. Suddenly you both trip and skin your knees – badly. You roll around in the dirt, and then you don’t wash your wounds. Obviously, your knees get really, really infected and they start to ooze. Next day you both go to the school nurse. She determines that your oozing wounds aren’t
that bad. In fact, she takes a cotton swab and transfers some of the “ooze” from your knee to your friend’s knee so it will get better faster. Wait a minute! Yuck! Why would she do that?

Infection was a huge problem during the Civil War. And, to make matters worse, doctors thought pus was a good sign and they transferred it from patients who had it to those who didn’t.

A doctor’s assistant wrote, "It was common to see a doctor with his sleeves rolled up to his elbows, his bare arms as well as his linen apron smeared with blood and his knife...held between his teeth."
http://www.civilwar.org/education/pdfs/civil-was-curriculum-medicine.pdf
 
Bumping this thread because I'm reading "The Lost Papers of John Bell Hood," and the doctor's reports mention laudable pus.

Not all pus was considered laudable - laudable was an adjective and pus could be bad pus as well as good pus. For example, the doctor's entry Oct. 11 describes pus from an abscess on Bell's stump as "decreasing and more laudable." Pus which smelled bad or was watery was not considered a good sign.

Medscape has an article on the history of infection control which discusses the reasoning behind the belief that pus was laudable or necessary to healing.

http://www.medscape.com/viewarticle/503947

That surgeons welcomed the sight of a purulent wound may be explained by the environment in which they were forced to practice. Wounds could be classified into two different categories: those with suppuration and those without. Wounds productive of a creamy, yellow ooze tended to run a chronic course, taking months to heal, but the patients were generally free of systemic symptoms.[15] As Alexander[1] recounts, it was noted by Steven Smith as late as 1887 that "amputation wounds rarely, if ever, recovered at Bellevue, except after long-continued suppuration." Conversely, a thin, watery discharge was associated with a fatal outcome, with the patient dying of sepsis within days. With an infection rate of almost 100%, a purulent wound represented the lesser of the two evils. Therefore, it is of little wonder that even the most conscientious surgeons preferred and even encouraged the formation of pus.

Since pus is made up largely of dead leukocytes (white cells), which are produced by the body to fight infection, this observation was not necessarily mistaken - pus was a sign that the body was fighting the infection locally, rather than allowing it to become systemic sepsis. However, the inference that the pus itself was doing the fighting and that spreading pus from an locally infected wound to a clean wound would help was clearly a terrible error. The white cells in pus are dead, and spreading somebody else's dead white cells plus a lot of live bacteria on a wound is only going to spread the bacteria, not cause the second person to produce more live white cells than they were already producing.
 
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A visit to a Civil War hospital, to check on a wounded comrade, would no doubt send many staggering away, gagging.
This veteran spoke of that in his memoir.
51WQ0V9NG7L._SX304_BO1,204,203,200_.jpg
 
I am regretting having read this after having eaten yogurt.

Of course the heading "laudable pus" has a way of stopping you right the heck in your tracks.
Yeah. It just caught my attention while scrolling through this forum/page for the first time.
 
Not all pus was considered laudable - laudable was an adjective and pus could be bad pus as well as good pus. For example, the doctor's entry Oct. 11 describes pus from an abscess on Bell's stump as "decreasing and more laudable." Pus which smelled bad or was watery was not considered a good sign.

Medscape has an article on the history of infection control which discusses the reasoning behind the belief that pus was laudable or necessary to healing.

http://www.medscape.com/viewarticle/503947

Any other medical professionals want to help me with this? @chellers ?
In the article it states that "a thin, watery discharge was associated with a fatal outcome, with the patient dying of sepsis within days". What they are describing sounds like a serousanginous discharge, which may indicate additional tissue trauma if prolonged, but not infection.
Any hypothesis as to why the patients we now know had healthier wounds had a higher mortality rate?
 
Any other medical professionals want to help me with this? @chellers ?
In the article it states that "a thin, watery discharge was associated with a fatal outcome, with the patient dying of sepsis within days". What they are describing sounds like a serousanginous discharge, which may indicate additional tissue trauma if prolonged, but not infection.
Any hypothesis as to why the patients we now know had healthier wounds had a higher mortality rate?
"What they are describing sounds like a serousanginous discharge, which may indicate additional tissue trauma if prolonged, but not infection." This is correct.

I've not read the article, but at a glance it looks interesting. Serous fluid is typically thin and clear, and is not an indication of infection. Serosanguinous does contain blood and serous fluids and does indicate trauma. Purulent (pus) drainage indicates infection and should never be applied to any other wound, as was commonly practiced. Purulence is the thicker yellow accumulation of dead white blood cells that are the body's response in fighting infection.
 
Any other medical professionals want to help me with this? @chellers ?
In the article it states that "a thin, watery discharge was associated with a fatal outcome, with the patient dying of sepsis within days". What they are describing sounds like a serousanginous discharge, which may indicate additional tissue trauma if prolonged, but not infection.
Any hypothesis as to why the patients we now know had healthier wounds had a higher mortality rate?
My assumption would that since due to a lack of understanding of hygiene, close to 100% of wounds were actually infected, ones which lacked pus were frequently a sign that the immune system wasn't even trying, not that there was no infection. For similar reasons, fever in illness was sometimes regarded as a good sign.
 
My assumption would that since due to a lack of understanding of hygiene, close to 100% of wounds were actually infected, ones which lacked pus were frequently a sign that the immune system wasn't even trying, not that there was no infection. For similar reasons, fever in illness was sometimes regarded as a good sign.
I like your theory. My initial reaction is to think that a lack of pus would denote some sort of underlying immune compromise, and what are the chances of all those men being compromised prior to being wounded? However, I suspect many of these men were severely nutritionally deficient, and that may have led to a decrease in the production of white blood cells.
 
My assumption would that since due to a lack of understanding of hygiene, close to 100% of wounds were actually infected, ones which lacked pus were frequently a sign that the immune system wasn't even trying, not that there was no infection. For similar reasons, fever in illness was sometimes regarded as a good sign.
I like your theory. My initial reaction is to think that a lack of pus would denote some sort of underlying immune compromise, and what are the chances of all those men being compromised prior to being wounded? However, I suspect many of these men were severely nutritionally deficient, and that may have led to a decrease in the production of white blood cells.
With all due respect, at best this is speculation and could not be confirmed without comprehensive CBC and Blood Chemistry Analysis. Such tests are not available in the 1860s.
 
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