Modern surgery, general and operative . ds), after any cutting operation, and afterthe infliction of a fracture, avoid as much as possible and for some time move-ments or handling, as fragments of thrombus may be detached. In mesenteric embolism exploratory laparotomy may disclose a perfora-tion which can be closed or a portion of gangrenous gut which can be resected. In aseptic pulmonary embolism enforce absolute rest, give strychnin andmorphin hypodermatically, and inhalations of oxygen. Trendelenburg hassuggested operation for occluding pulmonary embolism (see page 1028). In septic embolic
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Modern surgery, general and operative . ds), after any cutting operation, and afterthe infliction of a fracture, avoid as much as possible and for some time move-ments or handling, as fragments of thrombus may be detached. In mesenteric embolism exploratory laparotomy may disclose a perfora-tion which can be closed or a portion of gangrenous gut which can be resected. In aseptic pulmonary embolism enforce absolute rest, give strychnin andmorphin hypodermatically, and inhalations of oxygen. Trendelenburg hassuggested operation for occluding pulmonary embolism (see page 1028). In septic embolic pneumonia pursue the conservative plan of treatmentunless a large pulmonary abscess forms or an empyema arises. In either caseoperate to remove pus. Fat=emboIism in the human being was first noted by MacGibbon, of NewOrleans, in 1856, and was first thoroughly described by von Recklinghausen inalthough Magendie, in 1827, and Virchow, in 1856, developed it experi- mentally in animals. It is a processcapillaries of liquid fat after injury. which leads to an accumulation in theto adipose tissue, high tension havingforced the fat into the open mouths ofveins. Fat may be forced into openveins by muscular action, by efforts atrepair, or by concealed bleeding. Fatmay get into the blood by means of thelymphatics and it can also enter by wayof the synovial membrane. Wilms be-lieves that fat reaches the veins by wayof the lymphatics and the thoracic duct.Fat in the blood is quite a commoncondition, but seldom produces serioustrouble, although it is occasionally fataland is responsible for some otherwise in-explicable sudden deaths after fractures.Fat-embolism may arise during osteo-myelitis, after extensive bruises, crushes, lacerations, amputations, fractures, re-sections, or rupture of the liver. ^ In afatal case of mine it developed as a result of manipulation of a fracture ofthe neck of the femur. In another fatal case it followed amputation for cancerof the breast of a very fat woman.