GANGRENE. 
the Peruvian bark into a iseaee for every kind of gangrene. 
It is far from our intention to fay, that this medicine has not 
knowle edge e that i “ has 
; but we have 
‘harm has alfo arifen 
bark in fome examples in which it was not 
the ftomach with it on other 
prove ufeful. have been ST cned Yet ie man, that has 
feen any thing of furgery, can confcientioufly declare, that 
modern praétice is altogether delivered from fome abfur 
prejudices about ne virtues of a certain clafs of remedies, de- 
nominated antifeptic 
e truit, that the conreéinefs of the gers criticifms 
will become the more ftrik the further the reader ad- 
vances in the perufal of the acca which we have to offer 
the fubje&t, and the more he compares our ftatement with the 
fa&ts demonftrated to him by experience. 
We thali firft detail the common fympto s and appea' 
ances attendant on fuch mortifications as are preceded aes in- 
cae 
the part affeGted u ae 
greeable hiccough, repeated ficknefs, and rent rome 
of delirium, are ‘alfo the — Sanaa of this fort of 
local mifc mo 
T,.AR.4 
41 t 
In the of 
with a ia * Hfealownation, a cheap fuceeffively from a 
red toa yellowith, and, laftly, a greenifh hue. he cuticle, 
in various placcs, rifes in the form of veficles, which are gene- 
rally filled with a turbid fluid. welling, tenfion, and 
hardnefs {ubfide, and, on touching the part, a soi age fenfa- 
tion 1 eneration 
lexe} 
¢:) 
lat 
2 
cn 
io) 
at 
a 
vq 
. 
mpletely s it retains fome of 
w che and fenfibility. It is pleaded to this firft age 
of mortification that the term gangrene 
n the organization of the co is totally deftroyed, 
etic with all veftiges of their. natural ae e, and the 
gangrenous place is converted into a cold, » fibrous, in- 
fen a — a Jphacelus, or complete morti an, is faid t 
have h 
nce the foft parts, in this dead, black condition, 
is ay named a /lough, exeept when the piece of fleth 
has. been killed with cauftic or fire, in which cafe the part 
which is ayes is more frequently called an e/char. 
When any confiderable portion of the body is affected with 
mortification, the ears always feems to fuffer a fudden 
and an alarming : e te immediately sug that 
peculiar ap} aie, atic Mr. ook on rup 
ers 
Ra think, that the bett pares a of mortification 
is that adopted by Mr. John Hunter, who remarks, that 
all” the fe cafes are of two — the one, without inflamma- 
wit 
power; but, fays he, in inflammation 
t, erminate in 
mortification, he is no increafe of pow t, on the con- 
trary, a diminution of it. He dee "that this lofs of 
power ion when joined to an increafed a€tio 
of mortification, by deftroying the balance which ought to 
er sii the power ae the aétion of every part. 
makes mention, alfo, of certain cafes of mor- 
tification, palit though they are preceded by inflammation, 
to have 
o not depend wholly upon it as a caufe, fe h 
fome peculiarity in their nature. Of this kind are the car- 
uncle, and th gh formed by the fmall-pox puftule. 
(See Hunter on the Blood, Inflammation, &c. p. 
Let us now take a view of the various remote caufes of 
gangrene and {phacelus. 
deferves particular attention. Parts wh 
Fryfipelas often brings on mortification ; 
ment fpecies of inflammation, 
e of i baat = 
ralytic condition. 
and {fo does an pea ap — 
ates known by the 
nerally ends in ee ‘ > ioneans 
m ngrene. At the fame on every man, at all con- 
verfant with furgery, kn at any ordinar 
3s apt to in a‘ mortification when’ the patient’s habit is 
arti ularl ; weak, irritable or u healthy, 
on ‘this 2 actount ee maki 
sor t 
n witht inevi tably 
falling into a ftate of mortification. Of this-nature are all 
tendons and fafciz, which often flough, while the fkin, which 
covers them, ‘is not affected with the fame kind of diforder. 
The reafon of this circumftance feems imputable to the infe- 
rior cies sbes 2 all tendinous ftru@tures. The fkin, which 
the fame time inflamed, appears to be faved by being 
with 
great vitality. 
with common inflammation, they are always very pron 
mortify, and this circumftance is probably owing: to ae 
fame principle, which makes inflamed tendons and fafcie fo 
readily flough ; for, alk eS ge bike tumours,, 
as well as all excrefeenc n the opinion o 
modern py nes ie farndthed ith Tels Titality than the ge- 
neralit uch gabe as enter ito the natural: and original 
fomcton of the body. 
e feveral remote caufes of gangrene, eryfipelas is is 
thought to be the moft frequent ; for, whenever this {pecies. 
of inflammation falls into the ‘fuppurative ftate, a great 
‘ deal of floughing is always produced wherever the matter. 
happens to be fituated;. and -fince, im eryfipelatous abfeeffes, 
the pus is not con nfined b: any furrounding clofure of ‘the 
interftices of the cellular fubftance with coagulating lymph,, 
we find t that the matter generally. finds its way. very ace 
fively 
