A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    138/878 (page 114)
    HOSPITAL GANGRENE. FHAGEDiENIC GANGRENE. Such a disease as that once familiarly known under the name of Hospital Gangrene is now rarely seen, although, from time to time, both in hospitals and in private, cases are met with, which resemble in many respects those of former years, when the disease committed such ravages among our soldiers and sailors, and when m civil hospitals also, so great was its prevalence and proneness to attack all open sur- faces, that it became altogether impossible to calculate with any degree of certainty on the results of surgical practice. It rarely happens now- a-days that a slight abrasion of the skin, or the wound of an amputa- tion, is attacked with sudden and severe inflammation which speedily assumes a gangrenous character, and then rapidly terminates in mor- tification; yet such cases do occasionally occur, although not with the frequency of former times, when, as was said of the Hotel Dieu, a student might learn how to perform amputation by seeing it done on the living body, but could never learn how to treat the stump from the same field of observation, as the patients operated on invariably died of this destructive malady. . The term Phagedaenic Gangrene is frequently used for this disease, too. Often there seems to be a mixture of erysipelas, gangrene, mor- tification, and ulceration, in the same case, as exemplified thus: on a trifling-looking sore on the glans penis, for instance, the proportionally slight inflammation which is present suddenly becomes more active; the surrounding redness assumes a darker hue; then it becomes blue and gangrenous, and the parts thus affected are converted into a slough, underneath which the process of ulceration goes on so rapidly, that as the dead part becomes loose, the space behind is evidently larger than under ordinary circumstances: moreover, on the comparatively more healthy surface left after the detachment of the slough, similar actions may again speedily ensue, and thus, in the course of a very few days, according to the extent of the attack, one half of the glans or one half of the penis, or more, may be destroyed. Sometimes the patient’s constitution seems but little affected; generally the pulse is rapid and full at first, but feeble as the destruction makes progress, the mouth dry, tongue foul, and indeed there are most of the symptoms ot that kind of fever which usually attends severe local inflammation, particularly great prostration of strength. In hospital practice I have seen many such cases; but the patients have generally been a - mitted with the malady upon them; neither the air of the hospital, nor any other supposed contagious influence about such establish ments, has been the cause of the disease. Occasionally, however,