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Updated: June 3, 2025
The disease is characterized by a slowly progressive necrosis and by a destruction of more or less of the cartilage and by the presence of fistulous tracts. Etiology and Occurrence. The disease is due to the introduction of pus producing organisms into the subcoronary region of the foot under conditions which favor the retention of such contagium and extension of infection into contiguous tissues.
It is probable that many of the cancer cells which are carried away in the blood or lymph stream undergo necrosis and fail to give rise to secondary growths. Secondary growths present a faithful reproduction of the structure of the primary tumour. Apart from the lymph glands, the chief seats of secondary growths are the liver, lungs, serous membranes, and bone marrow.
The gumma does harm by displacing and replacing the normal tissue elements of the part affected, and by involving these in the degenerative changes, of the nature of caseation and necrosis, which produce the destructive lesions of the skin, mucous membranes, and internal organs.
Morbific material is introduced into the region of the lateral cartilage by means of calk wounds and other penetrant injuries of the foot. A sub-coronary abscess which, because of lack of proper care or because of virulency of the contagium or low vitality of the subject, is quite apt to result in cartilaginous affection and its perforation by necrosis follows. Symptomatology.
"However, 'Re had the sense to write straight to you about it. I'll say that for her." Then she read the letter again while Sir Coupland spun out his cup of coffee. She was still dwelling on it when he looked at his watch suddenly and said: "I must be off. Consider Prince Hohenschlangen's necrosis!"
While the development of the collateral circulation after the ligation or obstruction from other cause of a main arterial trunk may be sufficient to prevent gangrene of the limb, it may be insufficient for its adequate nourishment; it may be cold, bluish in colour, and there may be necrosis of the skin over bony points; this is notably the case in the lower extremity after ligation of the femoral or popliteal artery, when patches of skin may die over the prominence of the heel, the balls of the toes, the projecting base of the fifth metatarsal and the external malleolus.
The leg is supported in such a manner that flexion of the carpus is impossible. Due regard is given to prevent chafing or pressure necrosis by contact of the skin with the braces this may be done by bandaging with cotton. The supportive appliance is kept in position for ten days or two weeks.
In the vertebræ, operative interference is usually restricted to opening and draining the associated abscess. #Nature's Effort at Repair.# In cases which are left to nature, and in which necrosis of bone has occurred, those portions of the periosteum and marrow which have retained their vitality resume their osteogenetic functions, often to an exaggerated degree.
The pus therefore tends to burrow along the line of the blood vessels and in the connective-tissue septa, till it either finds a weak spot or causes a portion of fascia to undergo necrosis and so reaches the surface.
As soon as he was able to write, his father would forward him the copy of his birth-certificate, and he would likewise answer in the sense agreed upon any letters of reference or enquiry: would state the apprenticeship to architecture with Praed A.R.A., and then the impulse to go out to South Africa, the slight wound David insisted it was slight, a fuss about nothing, because he had enquired about necrosis of the jaw and realized that even if he had recovered it would have left indisputable marks on face and throat.
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