. Medical and surgical therapy . case of dry gangreneof the fingers and part of the left hand of a patientwith haematoma of the axilla. But more commonlythe epidermis is detached, and blisters filled witha reddish serous fluid are formed. Later the skinturns black or greenish in colour, and becomes de-liquescent. This is the moist form of gangrene, and inactual practice it is almost the only form shall see the reason for this directly. The first appearance of gangrene is accompanied THERAPEUTICAL CONSIDERATIONS 73 by very strongly marked general symptoms. Thesesymptoms are assoc
. Medical and surgical therapy . case of dry gangreneof the fingers and part of the left hand of a patientwith haematoma of the axilla. But more commonlythe epidermis is detached, and blisters filled witha reddish serous fluid are formed. Later the skinturns black or greenish in colour, and becomes de-liquescent. This is the moist form of gangrene, and inactual practice it is almost the only form shall see the reason for this directly. The first appearance of gangrene is accompanied THERAPEUTICAL CONSIDERATIONS 73 by very strongly marked general symptoms. Thesesymptoms are associated with an intense toxscmiaoriginating at the seat of the disease, the onset ofwhich is dramatic in its suddenness. In the courseof a few hours the system is invaded by toxins inenormous quantity, and the patient succumbs rapidly,even amputation of the limb being unavailing. B. Ischcemic and septic gangrene.—This class of case-is characterised by the sudden development of veryserious infection. I need not repeat that shell-. FiG. 35.—Dry gangrene of the hand following a wound ofthe axillary artery. (Lefort.) splinter-wounds, owing to the septic condition of thetorn and lacerated tissues, specially predispose to theoccurrence of serious sepsis. Bullet-wounds, however,must not be regarded as immune. Here the trackis distended by the effusion of blood, which forcesit apart and, as in the case of shell-wounds, formsa kind of deep-seated incubation chamber, where thecolonies of microbes carried in by the bullet maymultiply at their ease. The bruised and ragged track of a shell-wound,excluded as it is from light and air, is a singularlyfavourable milieu for the development of the germs 74 WOUNDS OF THE VESSELS conveyed by the missile and the debris which itcarries with it. They develop with incredible rapidity,and in a few hours induce very serious local sepsis,generally with the formation of gas in the arises the most serious form of gas gangrene,which originates a
Size: 2074px × 1205px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
