SPECIFIC TBAUMATIC INFECTIOUS DISEASES 35 



Owe the symptoms of malignant CBdema. 



High, fever ; a rapidly spreading oedema about the in- 

 fected wound. The swelling when stroked with the hand or 

 finger emits a fine crepitus, feels doughy and is very painful 

 at the circumference, but cold and painless at the centre. 

 The sloughing tissues are surrounded by a thin, putrid fluid; 

 the discharge is sanious and foul smelling. Further, symp- 

 toms of enteritis and pulmonary dyspnoea. The rapidly 

 spreading gangrene with the presence of an emphysemic 

 oedema are pathognomic. 



Nam,e the salient post-m,ortem, changes of m,alignant oedema. 



The subcutaneous tissue is infiltrated with a lemon- 

 colored jelly, the surrounding muscles likewise, emitting also 

 the foul odor of putrefactive gases. The fluid flowing from 

 the parts is yellowish red, foams slightly and is of putre- 

 factive odor. There is severe inflammation of the gastro- 

 intestinal mucous membrane, also pulmonary oedema, but no 

 swelling of spleen. 



Sow does m,aUgnant oedema terminate ? 



As a rule, by death in one to three days ; very rarely, by 

 abscess formation and recovery. 



How do you treat malignant oedema ? 



Deep incisions, removal of all sloughs, antiseptic irriga- 

 tions, drainage. 



Tetanus. 



A specific, traumatic, infectious disease, caused by the 

 action upon the central nervous system of the strychnine-like 

 toxin of the tetanus bacillus. 



