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Wednesday, Feb 11th, 9:30 A. M., pulse 90, temp. not taken. Condition good. Ordered a laxative. Friday, Feb 13th, considerable inflammation over the left iliac crest, in the centre of which, a spot as large as the thumb nail, looks gangrenous. The inflammation extends over a surface as large as the two hands. Some bullae or blebs have formed in the vicinity of the gangrenous spot.
Gangrenous spots followed by rapid destruction of tissue appeared in some cases where there had been no known wound. Without such well-established facts, it might be assumed that the disease was propagated from one patient to another.
In the thoracic form, the symptoms are bloody discharge from the nostrils, salivation, rapid, difficult breathing and swelling in the region of the throat. Local or skin lesions may occur in conjunction with, or independent of, the above forms of disease. These are carbuncles one or two inches in diameter that are hot and tender at first, but later become gangrenous, diffused swellings.
Many were lying in the filthy sand and mud. He went on and described the terrible condition of men dying from scurvy, diarrhea, gangrenous sores, and lice. He wanted to carry in fresh vegetables for the sick, but did not dare, the orders being very strict against such thing.
It is to be borne in mind that the object of amputation in these cases is merely to remove the gangrenous part, and so relieve the patient of the discomfort and the risks from infection which its presence involves.
The gangrenous mass was without true pus, and consisted chiefly of broken-down, disorganized structures. The reaction of the gangrenous matter in certain stages was alkaline. 9th.
The end of a stump, after spontaneous separation of the gangrenous portion, requires to be trimmed, sufficient bone being removed to permit of the soft parts coming together. If moist gangrene supervenes, amputation must be performed without delay, and at a higher level. #Gangrene from Heat, Chemical Agents, and Cold.# Severe #burns# and #scalds# may be followed by necrosis of tissue.
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