On the surgical complications and sequels of the continued fevers / by Willialm W. Keen.

Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: On the surgical complications and sequels of the continued fevers / by Willialm W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    noma, or cancruin oris. This is especially frefiuent in children and in the anu}'. Murchison speaks of it in the Crimea, as frequent and invariably fatal; Chdnu, however, in his report does not name it. Its I’avagcs arc extremely extensive, often involving even the bones. The ear, also, and the ej’elids are sometimes destro3’cd. From each of these, singly or all together, the most frightful deformities often follow, which require the utmost ingenuity in the plastic operations necessary to remedy them. In many cases the gangrene is local and subcutaneous, producing ne- crobiotic masses of tissue, which are, I believe, often, if not generall}', the cause of the abscesses so commonly seen in all parts of the bod^L Sometimes even the mediastina are opened, the anterior from the chest wall, the posterior from the deep tissues of the neck unless, by a timely surgical operation, the danger be averted. The male genitals are occasionally destroj-ed to a greater or less extent. Except the organic destruction, no special result follows, except, possibly, hemorrhage, for one case is recorded of death from a hemorrhage of flsxxx from the scrotum.’ That the perineum and the female genitals are not more frequently' the seat of gangrene, is rather surprising, when we consider the neglected condition of many of the patients and the constant soiling of the parts, as a result of unconscious and unavoidable discharges, especially in females. The troubles of the female generative organs are either distinct external gan- grene, or gangrenous ulcers in the vagina. I have found 9 cases, 8 from typhoid and one from typhus ; all in young per- sons from 17 to 27 years of age, except one of 84. In fi of the cases there was gangrene of the labia, extending sometimes to the ])erineum and the thigh. At least one case was followed by ' See Hihliop. Frneiitzcl, Werner, and lloffinan, p. 388. * .Murcliison, p. 194.