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

  • William Walsham
Date:
1896
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 Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    53/848 (page 51)
    due to the breaking down of gummata. They are circular or oval in shape ; their edges are steep, sharp-cut, slight]}^ scooped out, and of a dull red color ; and their base is depressed and covered with a yellow wet-wash-leather-like slough and the debris of breaking-down tissue. They leave slightly depressed, white cica- trices, often surrounded with pigmentation. Treatment.—Con- stitutionally, iodide of potassium should be given in full doses, combined in obstinate cases with small doses of mercury ; whilst locally a poultice may be applied till the slough has separated, and then black wash, iodoform, or the red oxide of mercury ointment. Goaty ukers are such as are met with over gouty parts. They are small and superficial, and the discharge as it dries leaves a chalk-like deposit of urate of soda on the surface of the ulcer. The treatment is that for gout. The scorbutic idcer.—Should an ulcer exist in a person affected with scurvy, its surface becomes covered by a spongy, dark- colored, strongly-adherent foetid crust, the removal of which is attended with free bleeding, and is followed by the rapid repro- duction of the same material. The treatment is that for scurvy. Lupous, epithelioma toils, rodent, carcinomatous, and sarcoma- tous ulcers will be found described in the sections on Lupus, Tumors, etc. GANGRENE OR MORTIFICATION. Although gangrene may occur from causes other than inflam- mation, it is, as we have seen, one of its results, and is therefore described here. It differs from ulceration in that the affected tissue dies en masse instead of in a molecular manner. Ge?ieral outline of the process.—Let us take as our type gan- grene as it occurs in a superficial part as the result of inflamma- tion. The part which was previously hot, red, painful, and swelled, becomes cold, gradually falling to the temperature of the sur- rounding medium. The pain, which just before the gangrene sets in is often of a peculiar burning character, ceases, and sensation is completely lost both to the touch and to other external stimuli. The skin, formerly red, becomes of a peculiar pale earthy color, mottled in places with patches of green or red. Now the cuticle separates in the form of blebs, or can be removed by gentle rub- bing, leaving the dermis below wet and sUppery. A peculiar crepitant sensation is felt on pressure, on account of the forma- tion of putrescent gases in the tissues, which, if cut into, are found stained and infiltrated with a reddish fluid. The part next becomes blackish-brown, and exhales the pecuhar odor of decom- posing animal matter. Supposing the process ceases to spread,