Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    their separation is attended by much su2ipnration. As the nerve-endings are completely destroyed, the pain is much less than in the former degree of burn. The ejiithe- lium which covers in the granulating surface is only derived fi-om the margins of the burn, and the resulting scar consists of dense fibrous tissue. Hence the extensive contraction and gi'eat deformity which often result. oTH DEGKEE.—Penetration of the deeji fascia and implica- tion of the muscles.—Great scarring and deformity neces- sarily follow. 6th degree.—Charrinr/ of the whole limb.—The parts are separated by ulceration in the same way as in gangrene. CoNSTiTiiTiox.\x EFFECTS.—T\Tien the burn is super- ficial and of small extent, there may be no constitutional S3,Tnptoms ; and even when it is deep, but limited to one of the extremities, as the foot or hand, they may also be sHght. When, however, the burn is extensive, and especially when it involves the chest, abdomen, or head and neck, even although it is only of the first or second degree, the syniptoms may be severe, more particularly when the patient is a child. They may be divided into three stages:—1. Shock and congestion. 2. lieaction and .inflcLmrnation. 3. Suppuration and exhaustion. 1st stage.—Shock cmd congestion.—The. shock is often yeiy great, especially when the burn is extensive, and involves the trunk, or head and neck. The patient is pale and shivering, the pulse feeble and fluttering, a,ud the extremities are cold; he suffers little or no paiii, and sometimes ])asses into a state of coma and dies, the chief post-mortem appearances being congestion of the internal organs, particularly the brain. 2XD STAGE. — lieaction and inflammation. — Eeaction comes on from twonty-four to iorty-eiglit hours after the burn. The pulse is full, stroiyj;','and rapid, the tem- perature rises, and there are other symptoms of fever. Inllammation is sot up around the burnt part, and there IS now danger of the absorption of the septic products derived from the putrefaction of the sloughs which aro begmmng to separate. The congestion of the internal yiscora, so conunon in the former stage, may run on into intlanimation ; and pleurisy, jmeunionia,, licritonitis, or menuigitis may Hup(irvoiu) and prove fatal. I'erforat- ing ulcer of tlie duodenum, attril)ut(!d to ]?runner's glands taking upou themselves the function of the
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