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Updated: May 3, 2025
Straw goods produce a fine dust, and cause a constant hacking among the girls at work upon them; and the acids used in setting the colors often produce "acid sores" upon the ends of the fingers. In match-factories, as already mentioned, even with the usual precautions, necrosis often attacks the worker, and the jaw is eaten away.
Even at a distance from the actual necrosis there is formation of new bone by the marrow; the medullary canal is often obliterated, and the bone becomes heavier and denser sclerosis; and the new bone which is deposited on the original shaft results in an increase in the girth of the bone hyperostosis.
The best defined group is that of the granulomata, which includes such important diseases as tuberculosis and syphilis, and in which different types of chronic inflammation are caused by infection with a specific organism, all having the common character, however, that abundant granulation tissue is formed in which cellular changes are more in evidence than changes in the blood vessels, and in which the subsequent degeneration and necrosis of the granulation tissue results in the breaking down and destruction of the tissue in which it is formed.
Small areas of necrosis appear on the pads of the fingers and of the toes; also at the edges of the ears and tip of the nose. Occasional symmetric patches appear on the limbs and trunk, and in extensive cases terminate in gangrene.
The subject was not observed thereafter and the outcome in this case is not a matter of record. Whether there existed a psoic phlegmon due to metastatic infection or necrosis of a part of a lumber or dorsal vertebra is a matter for speculation.
In this connection Young mentions a patient of sixty-five who in January, 1860, injured his right thumb and lost the last joint by swelling and necrosis. Chloroform was administered to excise a portion of the necrosed bone and death ensued. Recently, Dalton records a remarkable case of stab-wound of the pericardium with division of the intercostal artery, upon which he operated.
In exceptional cases the necrosis involves the entire vertical plate of the frontal bone. Gummatous disease in the wall of the orbit may cause displacement of the eye and paralysis of the ocular muscles. [Illustration: FIG.
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.
Its surface is at first smooth and shiny, but as necrosis of the tissue elements takes place in the centre, it becomes concave, and in many cases the epithelium is shed, and an ulcer is formed.
If the gummatous tissue degenerates and breaks down, and especially if the overlying skin is perforated and septic infection is superadded, the bone disintegrates and exhibits the condition known as syphilitic caries; sometimes a portion of bone has its blood supply so far interfered with that it dies syphilitic necrosis.
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