38 CLINICAL APPLIED ANATOMY. 



infection. Absorption of toxic products from septic regions after 

 the destruction of skin by heat, and their excretion with the 

 bile into the duodenum, embolism of an artery of the mucous 

 membrane of the duodenum and subsequent action of the gastric 

 secretion on the bloodless part, and over-activity of Brunner's 

 glands after destruction of many of the sebaceous glands of the 

 skin, have all been put forward as explanations of the origin of 

 the ulcer. 



It is important to bear in mind that scalds of the mouth and 

 fauces may be followed by oedema of the aryteno-epiglottidean 

 folds surrounding the superior opening of the larynx, causing 

 severe dyspnoea necessitating tracheotomy. 



All burns or scalds which have involved the true skin or deeper 

 structures are apt to be followed by contraction, which in certain 

 positions may lead to very marked deformity and disorganisation 

 of the functions of the part. This is particularly so in the 

 flexure of joints, as for instance when the sleeve of a dress has 

 caught on fire, and the skin of the bend of the elbow is destroyed ; 

 the resulting contraction will then effectually prevent proper 

 extension of the elbow. A burn involving the front of the upper 

 part of the neck may induce such contraction as to draw down 

 the chin and the mandible together with the lower lip towards 

 the sternum, and thus seriously interfere with the closure of the 

 mouth and with mastication. 



