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The doctor had diagnosed with rapidity. Supervening upon her ordinary cardiac attack after supper, Mrs. Maldon had had, in the night, an embolus in one artery of the brain. The way in which the doctor announced the fact showed to Rachel that nothing could easily have been more serious. And yet the mere naming of the affliction eased her, although she had no conception of what an embolus might be.
What was a pity she did not divulge to herself. She concluded with, 'Well, well, the childless father no sinners, and hastily shut her eyes, realizing that another 'Amen' had nearly come. Edward's voice had taken a tone of relief which meant the end of a prayer. Mrs. Marston glanced up at him, and decided to put some aniseed in his tea. 'High thinking's as bad as an embolus, she thought.
When an embolus becomes impacted at the bifurcation of the popliteal, if gangrene ensues it usually spreads well up the leg. When the axillary artery is the seat of embolic impaction, and gangrene ensues, the process usually reaches the middle of the upper arm.
It's very improbable that she'll regain consciousness." "But are you sure, doctor?" Rachel asked. The doctor answered grimly "No, I'm not I'm never sure. She may recover." "She's been rather disturbed this afternoon." The doctor lifted his shoulders. "That's got nothing to do with it," said he. "As I told you, she's had an embolus in one artery of the brain.
Treatment. The general treatment of embolic gangrene is the same as that for the senile form. Success has followed opening the artery and removing the embolus. The artery is exposed at the seat of impaction and, having been clamped above and below, a longitudinal opening is made and the clot carefully extracted with the aid of forceps; it is sometimes unexpectedly long (one recorded from the femoral artery measured nearly 34
Sometimes the thrombus is mixed a red thrombus being deposited on a white one, it may be in alternate layers. When aseptic, a thrombus may become detached and be carried off in the blood-stream as an embolus; it may become organised; or it may degenerate and undergo calcification.
#Dry Gangrene# or #Mummification# is a comparatively slow form of local death due, as a rule, to a diminution in the arterial blood supply of the affected part, resulting from such causes as the gradual narrowing of the lumen of the arteries by disease of their coats, or the blocking of the main vessel by an embolus.
#Prognosis.# When natural cure occurs it is usually brought about by the formation of laminated clot, which gradually increases in amount till it fills the sac. Sometimes a portion of the clot in the sac is separated and becomes impacted as an embolus in the artery beyond, leading to thrombosis which first occludes the artery and then extends into the sac.
These are most frequently situated in the lungs, except when the primary growth lies within the territory of the portal circulation, in which case they occur in the liver. The secondary growths closely resemble the parent tumour. Sarcoma may invade an adjacent vein on such a scale that if the invading portion becomes detached it may constitute a dangerous embolus.
The extent of the gangrene depends upon the site of impaction of the embolus, thus if the abdominal aorta becomes suddenly occluded by an embolus at its bifurcation, the obstruction of the iliacs and femorals induces symmetrical gangrene of both extremities as high as the inguinal ligaments.
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