GANGRENE. 
Sively in different = occafioning gangrenous diforder 
wherefoever it happens to fpread. In many of thefe in- 
{tances all the ee cate is beneath the {kin, chiefly affecting 
the fafciz, tendons, and ce loa fubftance. In fome cafes, the 
n does not — fave it, a 
ome occafions, 
ity of integuments deftroyed is s large; in other ex- 
pe it is {mall, while the eal i oe mifchief is 
.confiderable. Sometimes, alf floughing is the con- 
fequence of eryfipelas, the ne are not confined to the 
cellular fubftance, tendons, aponeurofes, and fkin; but the 
aulcles: large veffels, and bones are alfo deftroyed, fo that 
the whole thicknefs of the limb is left in a complete ftate of 
{phacelus. 
ete ing which entirely cuts off the sip rene fopply of 
ood to a part may aa The 
ccafion of a 
fo 
sper eee ome ‘et a oe 
Ti 
andage is 
mours, and other — {wellings, the sear of which is re- 
prefented as hindering the influx of blood into the part. e 
offified ftate of the: a in old perfons, is alfo fet down as- 
ecoming a caufe of mortification, by impeding the due fup- 
ply o of blood. 
Mortification will alfo be occafioned by any circumftance 
ength, the r 
foft, a lemaouss se Srna ie black, infenfible, and 
fetid. Here the f what ‘differ rent from 
efs, and a diminution of its fize; then it be- 
comes infenfible, fhrivelled, black, and lifelefs. 
Mortification frequently attacks patients whofe satan 
compel to remain a long while in bed in the fame pofture. 
In this example, the floughing is chiefly sentinel to the 
unremitted ae which eben uftain, an obftructs 
the circulat urgeons have frequent o opportunit ies of 
beholding melancholy as of this kind of mortification, 
sala aa in cafes of fractures, paralyfis from difeafed 
ertebre, The mifchief moft readily occurs where the 
ioe have. the leaft flefh upon them, and, confequently, 
where all external preflure muft operate of ye yokes os 
effe& ; as, for inftancé, about the os facrum um, 
chanter major, the {pine of the feapula, &c. The difordored 
part, in _ cafe, always becomes at firft foftifh, livid, red 
at the c Gammicfence. and cedematous, phate entirely 
lofing re “fenfibility, and acquiri ee 
‘When the flough is detached, a fou fpreading 
ways left. rom long confine ment 
afions eee tion, when 
ae ie i circumftanced. 
fever, er par. arias. ae languid eee on of old age, 
c.-all render the assed more éafy of produétion. 
0 ome of the remote caufes of mortification aiee by 
actually Give the organization o art. 
ais compound fractures, attended with: extenfive injury 
‘pofe the flefh at once ; 
‘into two a one preceded by inflam. 
. turn black, but to retain nearly their natural colour. 
Previous: 
of the foft parts, and a wound of the main — of the 
limb ; ve large contufed lacerated wounds, 
duce gangrene and epee The aGtion of fire ane cauttic 
fubftances may be faid to bring on floughing on the fame 
principle ; ; for a rota dellrudticn of all natural organization 
muft be the sea eae of the chemical decompofition of 
any part of We fhould obferve, iba = 
that the heat coed aad be very gra to kill and d 
and that, when mortilicatien “arifes 
from burns, under any other circumftances, the affeCtion 
mult be preceded by inflammation. 
grees of cold will often give 
tife to gangrene and {phacelus, partieulsly when the benumb- 
ed frozen ola are impradent ye 
re. In cir 
» a 
mation is fudilenly eee wick rapidly ends in a mortifi- 
cation. Bad chilblains affo uch a 
cale 5 3 whi ea Aevere one may be feen in the iheccias: of a 
Cold will more readily make parts flough, 
ae ae fyitern is debilitated by poor living, or any pre- 
vious difeafe. e have feen, in the hofpitals of the metro- 
polis, marfy Lafcars, whofe feet aa piece in confequence 
of the cold of aun ate, and wa ae rin lee 
In former times, alfo, numerous Africas ut of ae 
ufed to be feen in the London hofpitals, ae es ae 
fometimes in a ftate of {phacelus, from the combined effet. of 
are or cruel preffure’ 
The corm a poe Ay fol Ween parts we fhall pre- 
fently confider 
The furunculus and carbuncle are difeafes which are alway 
attended with a greater or a lefs degree of gangrenous ae 
order, as per’ se = learn more particularly: oy a melon 
ence -to tho 
ne feation i is s flated to originate fometimes bs rom un- 
known epidemic caufes; and inftances are men 
ho 
up the le 
all prefently Soh -" 
ular cafe. 
and the divifion of thé diforder: 
mmation, pu other not, 
we now pro o the pea ee tion of fome other circim- 
flances a eh ead sone on, before we Gr: to fpeak . 
of the treatment. 
Befides the divifion of mortifications into fuch as are pre- 
ceded a ses angles and into others which are not, fur- 
made fome saa diftin&tions ; for, in- 
H 
the sete doy remote cau 
Hance, the mats a ae gangrenes 5 the white gangren 
o firft kinds are a ae ifed by the little or 
great peo “of for aes about the {phacelated p 
at ; 
danus, Tulpius, Quefnay; Bertrandi, and others have eated 
of the dry gangrene in their refpedtive writings. 
In the white gangrene, the’mortified parts are faid not to 
Quef- 
nay has taken particular notice of this curious variety of. 
the diftem 
A or Ged part may be confidered, in relation to the reft 
of the body, as an extraneous fubftance, the feparation. of 
which will be equally conducive to the ee i recovery ° 
: the lee viii it fhould oe that a flough: 
oval as foon as it is formed; for al-- 
though, ‘there i is no “vital ‘conneétion ee een a the dead and 
iving 
