Volume 1
A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.
- Date:
- 1907-10
Licence: In copyright
Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
91/986 (page 67)
![junctival ccchyiiioses, cloudiness of cornea—tliese are the external ocular changes re])orted. In a certain nninher of cases j)rofound altera- tions of the eye were noticed, viz., apoplectie hemorrhages in the retina, with pigmentation, tearing, bleeding, and rupture of the choroid, irido- cyclitis, luxation of the retina; ansemia of the optie nerve, optic atro- phy, and blindness. Fuchs, Knies, Meyerhofer, Priendisberger, and Vossius, report the formation of cataract. Hess observed, experimentally, cataract formation in animals. Disturbances of the auditory apparatus occurred in many cases. Pain in the ear, with difficulty of hearing, are fre- quent symptoms following electric shock. The writer recalls a case of ab- solute deafness in a man of tweny-five occurring after having been shocked by lightning. In this case Inhere was loss of consciousness and a partial hemiplegia on the left side; but the tleafness was complete in both ears. Only one month later improvement in hearing appeared. The patient recovered entirely. Clark, Ludewig and others report tears of the drum. Kayser and Freund report permanent deafness from paralysis of the eighth nerve, with or without simultaneous perforation of the drum. Gognel observed hemorrhages from the ear. Burns.—A conductor charged with electricity will produce burns in living tissue when it is brought in contact with the latter. Radiation of electric light may produce some superficial burns, but the appearance of the burns and the accompanying general symj)toms are different when electricity has a direct effect on tissue from immediate contact. The effect of a current is not always in direct relation with its strength, as sometimes currents of 5,000 volts produce only superficial burns, and of 500 volts deep burns. Individual circumstances accompanying the accident—dura- tion and degree of contact, dampness of skin, the degree of cleanliness of the latter—all are of great importance as to the effect of the contact. In electrical burns all the tissues, from the epidermis to the bones, may be affected. They may be superficial or deep. They are usually not limited to the dermis; the muscle and bones are also affected. The loss of substance may be small, or may invade a portion of the limb. Imme- diately after the contact the skin becomes black, and the affected portion is scron covered with a hard layer resembling parchment. During the process of reparation the wound acquires a red and smooth surface. There is never present at the ])eriphery that whitish ring which is found in ordi- nary burns. Electrical wounds never su[)purate and are never moist; the parchment-like layer is preserved until a new epidermis is formed. The characteristic feature of electrical burns consists in their absolute pain- lessness during the entire process of healing. The duration depends upon the degree of the burns; so that, when the bone is involved, the course will be prolonged and complications will set in. Superficial burns heal up entirely and rapidly. In deep burns gangrene may occur and necessitate amputation of the limb. Burns may be accompanied by a nervmus shock more or less serious, frequently by syncope. The latter may be fatal and the patient dies in a few minutes despite all possible care. We said above that from a tension of 500 to f)00 volts U])wards, electrical accidents may be fatal. It is to be noted that the voltage alone does not determine tlie (piestion of death. Perhaps the danger lies in the fact that an electrical burn forms a bad contact by interposition of gaseous products between the tissue and the](https://iiif.wellcomecollection.org/image/b24907212_0001_0091.jp2/full/800%2C/0/default.jpg)
