68 
CRIMEAN RETROSPECTS. 
being interred. Weather had apparently not so much influ- 
ence ; for after a change in the direction of the wind, or 
during a close stagnant condition of the atmosphere, there 
were more deaths than during or after a storm. Now on 
those particular mornings, when, on looking out from my tent, 
I saw our French neighbours busy at work, as sure was I to 
find a large mortality amongst my patients, and so long as I 
had a number of sick, this was always the case. And even 
the diseases had points of resemblance in their low typhoid 
character, the rapidity with which they terminated in death, 
and their being almost beyond the influence of medicine. 
Their pathology, too, was similar, in their evidently depend- 
ing on some morbid poison circulating in the blood giving 
rise to, in my patients, ulceration of the mucous coat of the 
intestines; the deposition of miliary and confluent tubercle 
• in the lungs and numerous skin affections of a malignant 
character; while a fearfully large number were attacked with 
glanders and farcy^ which terminated in death in two or 
three days. 
The progress of wounds or injuries also indicated a viti- 
ated state of the system; for no matter how slight they some- 
times were, they were certain to assume a phagedenic con- 
dition, and spread over a large extent of surface in a short 
time ; indeed, there appeared to be a tendency towards break- 
ing up of tissue on the slightest aggravation. 
When the w^arm weather set in they were still more un- 
manageable, and I had many opportunities of confirming in 
my own mind what M. Renault has stated to be one of the 
causes of traumatic gangrene,* namely, “ the contact of putre- 
fying blood in or upon a wound.” In those desperate cases of 
fistulous withers, where the only chance lay in obtaining a 
wide dependant opening, and in wounds caused by the re- 
moval of tumours, or in any operation where much hemor- 
rhage was unavoidably produced, sloughing was certain to 
follow if the effused blood w r as not always removed ; and when 
this could not be done, gangrene was the prelude to the 
death of the animal. There appeared to be an inability 
generally, to form healthy pus, hence circumscribed abscesses 
were not often met with, for the fibrinous wall appeared too 
weak to withstand the corroding influence of the thin, fetid 
pus. Cicatrization was feeble, and could only be attained 
by scrupulous cleanliness, the application of stimulants, 
gentle and equable pressure, and paying as much attention 
to the general health as it was possible to do under the cir- 
cumstances. Without any assignable cause, large patches of 
* ' Gangrene Traumatique,’ Paris, 1840. 
