376 
SOCIETY MEETINGS. 
with granulations and recovery by cicatrization be complete in 
two weeks, but this termination is the exception rather than 
the rule, .for in most cases new, cutaneous areas and the deeper 
structures as well are invaded, sloughing extends to blood ves¬ 
sels, causing serious hemorrhage, tendons and ligaments are 
destroyed, even the capsular ligament, resulting in open joint; 
or it may extend behind the lateral cartilage, resulting in carti¬ 
laginous quittor. It is not often that these conditions are 
found excepting the destruction of the blood vessels, as in most 
instances the system ere this absorbs a sufficient amount of 
poison to produce a general septic condition that rapidly leads 
to death ; the difference in the termination probably being due 
to the ability of the system to resist the poison. When the 
patient has sufficient vitality to resist the generalization of the 
poison the destructive process extends to the deeper tissues of 
the affected limb and the worst appearing sore that can well be 
imagined will be the result. The vessels, nerves, tendons and 
ligaments having more power of resistance than the cellular 
tissue surrounding them, hence the latter is destroyed, leaving 
the former in position so that they are often plainly visible for 
several inches, even the bone may become exposed to view. 
The coats of the veins being the thinnest are usually the first 
to be destroyed after the cellular tissue and serious if not fatal 
hemorrhage results. 
The prognosis depends very largely on the extent and char¬ 
acter of the individual case. It is claimed by some that certain 
atmospheric conditions favor gangrene, and during such seasons 
many wounds are troublesome and at such times we would 
naturally expect gangrenous dermatitis to be more malignant. 
If the attack be mild and the invasion limited, prognosis is 
favorable, but if it is extensive and rapidly extending to the 
deeper structures, it is doubtful, and if ligaments, vessels and 
tendons are destroyed or generalized septicaemia is established 
the gravity of the case is greatly increased. 
Treatment: As the infection may take place through a very 
small wound, we will not be likely to succeed by preventive 
measures. The disease being rapid in its progress, treatment in 
the advanced stages is doubtful, and if successful the time re¬ 
quired to cicatrize the extensive wounds is so long the financial 
benefits to be derived by the owner from treatment is doubtful. 
Whatever therapeutic efforts are undertaken should be heroic 
and applied at the very earliest moment possible after the dis¬ 
ease begins. An antiseptic course locally as well as internally 
