. Surgery, its principles and practice . F NAVAL WARFARE. 1055 space, great pressure is developed as well as intense heat, which forcesthe gaseous products of combustion (carbon dioxid, carbon monoxid,hydrogen, nitrogen, and methane) into the tissues and is responsiblefor some of the effects produced.^* Burns are very extensive, affectingnot only the exposed parts, such as the face, neck, and hands, but as muchas two-thirds to three-quarters of the entire surface of the body from theburning of the clothes/^^ As a rule, they vary only in extent, theirdepth reaching not beyond the limits of the
. Surgery, its principles and practice . F NAVAL WARFARE. 1055 space, great pressure is developed as well as intense heat, which forcesthe gaseous products of combustion (carbon dioxid, carbon monoxid,hydrogen, nitrogen, and methane) into the tissues and is responsiblefor some of the effects produced.^* Burns are very extensive, affectingnot only the exposed parts, such as the face, neck, and hands, but as muchas two-thirds to three-quarters of the entire surface of the body from theburning of the clothes/^^ As a rule, they vary only in extent, theirdepth reaching not beyond the limits of the second degree, owing to the shortduration of the flame. There are many cases, however, which exceedthis average, and the blanched waxy appearance of the uninjured skinand mucous membrane, combined with the charred board-like hardnessof the integument, split open in many places, attest the enormous damageand destruction that is produced. The burned area is generally blackenedor browned bv the fumes and the unconsumed powder, and the hair. Fig. 535.—Gunshot Wocnd of the Abdominal Wall with Loss of Soft Tissues. is singed. Some are salivated, and all exhibit a huskiness of the voiceas if they had inhaled the hot gases. It is probable that many sufferfrom the internal effects of the flame. The constitutional symptoms vary to some extent, but in generalfollow rather a typical course. At first they denote great nen^ous exci-tation and apprehension, accompanied in some cases with night may be succeeded, through reassurance, by a permanent normalmental state, or in the most serious cases may pass beyond into a conditionof shock and collapse. Pain and thirst are intense. In cases whereinflammatory reaction sets in the temperature rises in a remarkablemanner, and the involvement of a considerable surface is usually attendedwith septic absorption. Necrosis and sometimes even dry gangrene areprominent among other compHcations. 1056 NAVAL SURGERY. The Fig. 536. that the treat
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