338 



Gaseous Edema 



The symptoms following infection are quite uniform, consisting 

 of redness and swelling of the wound, with rapid elevation of tem- 

 perature and rapid pulse. The wound usually becomes more or 

 less emphysematous, and discharges a thin, dirty, brownish, offensive 

 fluid that contains gas bubbles and is sometimes frothy. The pa- 

 tients occasionally recover, especially when the infected part can 

 be amputated, but death is the common outcome. After death the 

 body begins to swell almost immediately, may attain twice its 

 normal size and be unrecognizable. Upon palpation a peculiar crepi- 

 tation can be felt in the subcutaneous tissue nearly everywhere, 

 and the presence of gas in the blood-vessels is easy of demonstra- 

 tion. The gas is inflammable, and as the bubbles ignite explosive 

 sounds are heard. 



Fig. 121. "Frothy liver" from Bacillus aerogenes capsulatus infection 



(Aschoff). 



At the autopsy the gas bubbles are found in most of the internal 

 organs, sometimes so numerously as to justify the German term 

 " Schaumorgane " (frothy organs). The liver is especially apt to 

 show this condition When such tissues are hardened and ex- 

 amined microscopically, the bubbles appear as spaces in the tissue, 

 their borders lined with large numbers of the bacillus. There are 

 also clumps of bacilli without gas bubbles, but surrounded by 

 tissue, whose nuclei show a disposition to fragment or disappear, 

 and whose cells and fibers show signs of disintegration and fatty 

 change. In discussing these changes Ernst concluded that they 

 were ante-mortem and due to the irritation caused by the bacillus. 

 The gas-production he regards as post-mortem. 



In the internal organs the bacillus is usually found in pure culture, 

 but in the wound it is usually mixed with other bacteria. On this 

 account it is difficult to estimate just how much of the damage be- 

 fore death depends upon the activity of the gas bacillus. That 



