A manual of the practice of medicine / by George Hilaro Barlow.

  • Barlow, George Hilaro, 1806-1866.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of medicine / by George Hilaro Barlow. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    artery or from the use of diseased gi'ain, there is commonly no blackness or lividity. Mortification, or gangrene occurs most often either on the surface or extremities of the body, in the lungs, in the mucous membrane of the alimentary canal, particularly the stomach and large intestines, and in the peri- toneum, rarely in the other internal parts, except as the result of injury. Gangrene has a tendency to diffuse itself through any part which is aifected by it; fortunately, however, it generally happens where the inflammation has been less intense, or the living power gTeater, as in the part nearest the heart, that plastic lymph is thrown out, forming a stratum, or wall, by which the gangrenous structure is separated from the rest of the body; and, the affected part being separated from the surface of this layer, is said to come away by sloughing. When, indeed, the vital powers are very feeble, or the cir- cumstances attending the infliction of the injury which caused the inflammation have been such as to give a powerful de- pressing shock to the system, there may.not be sufficient power to produce this protecting wall of adhesive matter ; and the gangTene, spreading rapidly, is arrested in its progress only by the death of the patient. The conditions which induce this most destructive result of inflammation, are such as most impair the living power of the part affected, or of the system at large. Among the former may be reckoned, violent mechanical injury, intense heat or cold, and certain poisons (among the latter, the mor- bid poisons of plague, typhus fever, scarlatina, erysipelas, &c.); affections of the heart or large vessels obstructing or enfee- bling the circulation, and of the nervous centres, impairing the^ vital powers ; to these may be added, perhaps, the inju- dicious use of mercury, or other remedies which diminish the quantity of the fibrine, or lessen its coagulating property. It may be observed that, as ulceration consists (in a great degi'ee, at least), like sloughing, of a separation outiuardly of the diseased tissue, in contradistinction to its being taken up, into the system, by the process which we have spoken of as intersticia,! absorption, it may be said to differ from the latter rather in degree than in kind : but there is this further distinction, that in ordinary ulceration, after the ulcer has been established, portions of the affected tissue cannot be recognized in the discharge from the ulcer ; so that, in order to its removal, it must have previously undergone a molecular