. Surgery, its principles and practice . Fig. 426.—Local Necrosis and Gangrene at Point of Foreign Bodt with Perforation. rapid and complete in this case that there was no effort made by the wallof the appendix to fix itself to tlieneighboring tissues. We regardwith alarm a sudden drop in thetemperature and interpret it asmeaning, first, a cessation of ab-sorption, due, most commonly, toperforation, with diminished puspressure; second in frequency, tothe escape of the contents intothe intestine; third, to gangrene;fourth, to circumscribing tissueinfiltration with diminished ab-sorption (local
. Surgery, its principles and practice . Fig. 426.—Local Necrosis and Gangrene at Point of Foreign Bodt with Perforation. rapid and complete in this case that there was no effort made by the wallof the appendix to fix itself to tlieneighboring tissues. We regardwith alarm a sudden drop in thetemperature and interpret it asmeaning, first, a cessation of ab-sorption, due, most commonly, toperforation, with diminished puspressure; second in frequency, tothe escape of the contents intothe intestine; third, to gangrene;fourth, to circumscribing tissueinfiltration with diminished ab-sorption (local immunity); and,fifth, diminution of the virulenceof the flora. After fifty hours the clinicalpicture changes to that of infec-tions of the periappendical regions(perityphlitis or paratyphlitis). Ifthe perforation takes place intothe mesoappendix, or under cir-cumscribing adhesions, the clin-ical presentations are those of alimited infection, while if into thefree peritoneal cavity the symp-toms of a more or less diffuse peritonitis ma
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