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From what has been said, it will be gathered that in dry gangrene there is no urgent call for operation to save the patient's life, the primary indication being to prevent the access of bacteria to the dead part, and especially to the surface exposed at the line of demarcation.
Debt, which always grows, is certain to remain unless wholly extinguished. The same is the cause with defeated foes and neglected maladies. These always produce great feats. Every act should be done thoroughly. One should be always heedful. Such a minute thing as a thorn, if extracted badly, leads to obstinate gangrene.
In rags, almost barefoot, half-fed, often without fuel even to cook their food, in that terrible winter on the heights, whole regiments of heroes became extinct, because there was not sufficient administrative ability to convey the supplies to a perishing army! So wretched was the hospital service, that to be sent there meant death. Gangrene carried off four out of five.
The East will not be stained with the same atrocities as the West; the frightful gangrene of an enthralled race is not to mar the destinies of the family of Japhet in the Oriental world; humanizing, not destroying, as they advance; uniting with, not enslaving, the inhabitants with whom they dwell, the British race may," etc., etc.
What we call little things are merely the causes of great things; they are the beginning, the embryo, and it is the point of departure which, generally speaking, decides the whole future of an existence. One single black speck may be the beginning of a gangrene, of a storm, of a revolution. From one insignificant misunderstanding hatred and separation may finally issue.
As it chanced, although I was treated only with cold water, for antiseptics were then unknown, my young and healthy blood triumphed and no gangrene appeared. What made those days even duller was that during them I saw very little of Marie, who now only entered the place in the company of her father. Once I managed to ask her why she did not come oftener and alone.
To prevent the occurrence of gangrene from frost-bite it is necessary to avoid the sudden application of heat. The patient should be placed in a cold room, and the part rubbed with snow, or put in a cold bath, and have light friction applied to it. As the circulation is restored the general surroundings and the local applications are gradually made warmer.
The surgeons were too much engaged in transferring the men from the wagons to the houses to find time that day to dress many wounds, and many an unfortunate soldier whose stump of an arm or leg had not been dressed since the first day of the fighting, became the victim of gangrene, which set in as the result of this unavoidable want of care.
We are as yet ignorant of the true nature of the changes of the blood and tissues in scurvy, and wide field for investigation is open for the determination the characteristic changes physical, chemical, and physiological of the blood and tissues, and of the secretions and excretions of scurvy. Such inquiries would be of great value in their bearing upon the origin of hospital gangrene.
The whole phenomenon may be unilateral, as in Smith's case, quoted by Crocker, in a girl of three years in whom the left hand was cold and livid, while on the right there was lividity, progressing to gangrene of the fingers and of the thumb up to the first knuckles, where complete separation occurred.
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