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The edges are of a dull blue or purple colour, and gradually thin out towards their free margins, and in addition are characteristically undermined, so that a probe can be passed for some distance between the floor of the ulcer and the thinned-out edges. Thin, devitalised tags of skin often stretch from side to side of the ulcer.
She was bone of his bone and he had made no effort even for his own flesh. He had thrown her a burden on the convent that sheltered her so willingly only for want of will power to conquer the weakness that had devitalised brain and body. The thought crushed her. As she read his confession, full of tardy remorse, her proud heart had been sick with humiliation.
No wonder public-houses are the landmarks of London locomotion; they are the Temples of Oblivion, where the devitalised multitudes seek to forget themselves, that they may regain the courage to live at all. For myself, I had sense to know that stimulants of this kind were a remedy much worse than the disease. The only stimulant, at once safe and effectual, which I needed was fresh air.
The presence of a metallic foreign body having been determined and its position localised by means of the X-rays, all devitalised and contaminated tissue is excised, the foreign material, e.g., a missile, fragments of clothing, gravel and blood-clot, removed, the wound purified with antiseptics and closed or drained according to circumstances.
The more War becomes in this manner devitalised so much the more its theory becomes destitute of the necessary firm pivots and buttresses for its reasoning; the necessary is constantly diminishing, the accidental constantly increasing. Nevertheless in this kind of Warfare, there is also a certain shrewdness, indeed, its action is perhaps more diversified, and more extensive than in the other.
So long as the tissues are in a healthy condition they are able to withstand the attacks of moderate numbers of pyogenic bacteria of ordinary virulence, but when devitalised by disease, by injury, or by inflammation due to the action of other pathogenic organisms, suppuration ensues.
#Complications.# Diffuse suppurative cellulitis is the most serious local complication, and results from a mixed infection with other pyogenic bacteria. Small localised superficial abscesses may form during the convalescent stage. They are doubtless due to the action of skin bacteria, which attack the tissues devitalised by the erysipelas.
Thorough purification with antiseptics, excision of devitalised tissues, and drainage of the wound are first carried out.
It has others, especially one at the Château des Halles, thirty kilometers from Lyons, which take the devitalised, convalescent and tubercular cases. The Château des Halles is a splendidly built modern building, arranged in an ideal way for hospital use. It stands at the head of a valley, with an all day sun exposure and large grounds.
Devitalised and contaminated tissue is removed with the knife or scissors and the wound purified with antiseptics of the chlorine group or with hydrogen peroxide. If there is a reasonable prospect that infection has been overcome, the wound may be at once sutured, but if this is doubtful it is left open and packed or irrigated.
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