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"Yes, I suppose the blood has spread; there is what doctors call ecchymosis; give me some clean linen, pour into a glass equal parts of good olive oil and wine dregs, and wash that stain for me." "But, dear M. Chicot, what am I to do with this body?" "That is not your affair." "What! not my affair?" "No. Give me some ink, a pen, and a sheet of paper."
If a blow be inflicted with a blunt instrument, there is produced a bruise, or ecchymosis, of which it is unnecessary here to describe the appearance and progress. A bruise may be distinguished from a post-mortem stain by the cuticle in the former often being abraded and raised.
The symptoms are those common to all contusions, and the patient complains of severe pain on attempting to use the muscle, and maintains an attitude which relaxes it. If the sheath of the muscle also is torn, there is subcutaneous ecchymosis, and the accumulation of blood may result in the formation of a hæmatoma.
The patient experiences a sudden pain, with the sensation of being struck with a whip, and of something giving way; sometimes a distant snap is heard. The limb becomes powerless. At the seat of rupture there is tenderness and swelling, and there may be ecchymosis.
Shortly after, the placenta was expelled, and she proceeded on her journey, carrying the child in her arms. At 5.50 the physician saw the woman in bed, looking well and free from pain, but complaining of being cold. The child, which was her first, was healthy, well nourished, and normal, with the exception of a slight ecchymosis of the parietal bone on the left side.
This puncture was so severe that the arm was in a state of ecchymosis for six or eight inches upwards, and I doubt not that without the caustic, there would have been severe and long continued suffering, and perhaps painful suppurations.
The clavicle was fractured two inches from the acromial end, and the sternal end was driven high up into the muscles of the neck. The arm and hand were paralyzed, and the woman suffered great dyspnea. There was at first a grave emphysematous condition due to the laceration of several broken ribs. There was also suffusion and ecchymosis about the neck and shoulder.
The less severe forms of contusion are associated with ecchymosis, numerous minute and discrete punctate hæmorrhages being scattered through the superficial layers of the skin, which is slightly œdematous. The effused blood is soon reabsorbed.
Sometimes the hæmorrhage takes place apparently spontaneously from the gums, the nasal or the intestinal mucous membrane. In other cases the bleeding occurs into the cellular tissue under the skin or mucous membrane, producing large areas of ecchymosis and discoloration.
The staining is of a dull red or slaty blue colour. It must be distinguished from ecchymosis the result of a bruise, by making an incision into the part; in the case of hypostasis a few small bloody points of divided arteries will be seen, in the case of ecchymosis the subcutaneous tissues are infiltrated with blood-clot.
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