Selected Monographs.

  • New Sydenham Society.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Selected Monographs. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    25/372 (page 11)
    suffice under the influence of physico-chemical laws to produce mummification ; or this phenomenon (which is not produced normally upon a corpse, in which putrefaction always precedes desiccation), is the effect of a morbid evolution of a quite special character, and deserves to be studied as much as the inflamma- tory process. I hold that there was something fundamental in the distinction established formerly by Galen, and subsequently by Fabrice de Hilden, between gangrene and sphacelus, a distinction revived and definitely stated in our days by Thomson.* From this point of view gangrene would be none other than this morbid evolution of which I have spoken; sphacelus would be the con- firmed and irremediable condition. Unfortunately usage has prevailed in employing the two words as synonymous. After all it is of little importance to give a definition of gangrene, and it is even doubtful whether it is possible to give a sufficiently comprehensive one in the actual state of knowledge. That which is more interesting is to unravel what passes in the interior of a tissue which undergoes this alteration. It is this which I am about to attempt, restricting myself to dry gangrene. V. M. Cruveilhier was I believe the first to fully describe the variety which he calls gangrene by cadaverisation. It presents the greatest analogies, if not a perfect identity with what Quesnay called white gangrene.f The dead parts present themselves under the aspect of those of a fresh corpse, or of a limb which has just been amputated. This form is always accompanied by algidity (corpse-like coldness), and by a colour which is very striking (the colour of the corpse), and quite distinct from that of the adjacent parts. The epidermis is easily detached by friction. This symptom is observed especially in the cases where the death of the limb has taken place instan- taneously without prodromata, in consequence of the complete and sudden interception of the arterial blood, t M. Cruveilhier admits that cadaverisation, which may be con- sidered, according to his view, as the first period of gangrene is soon followed by the second period, which is at one time dry, * Lectures on Inflammation. t Op. ext., p. 337 and p. 348. ; Cruveilhier, Traite (Tanatomie pathologique yenerale, T. iv., p. 252.