374 
SOCIETY MEETINGS. 
by accumulations of pus or icbor in the costal or pulmonary wall. The pleura 
then assumes the appearance of a yellowish white, or more frequently of a black¬ 
ish or greenish brown lax or deliquesent slough, with superficial gangrene of the 
lung. 
Lungs .—Gangrane of the lungs is an affection of not infrequent oc¬ 
curence, and under certain hepatization of a portion of a lung is a most common 
complication. There are two distinct forms of gangrene of the lung, viz.: diffuse 
and circumscribed or gangenous eschar. In diffuse gangrene we find a portion 
of the lung presenting an abnormal greenish or brownish tint, filled with a similar 
colored, somewhat fatty, turbid serosity, soft, rotten, and breaking readily down 
into a pulpy, shaggy tissue. The whole evolves the characteristic odor of 
sphacelus. Towards the outer portion the discoloration, infiltration and alteration 
of consistence are less marked, and finally become impreceptible, and there is no 
line of demarcation between the gangrenous and the adjacent tissue, which only 
differs from the normal state in being oedematous and senemic. It corresponds 
to diffuse gangrene of the bronchial tubes, with which it is almost always associ¬ 
ated. Upon the whole it is a rare affection, but when it does occur it always 
attains a considerable extent, as it commonly attacks one or more lobes. It is, 
perhaps, scarcely entitled to rank as an independent affection, as it is generally as¬ 
sociated with eschar of the lungs, and hence it is more readily developed from the 
contract of the ichorous, gaseous and fluid products of the gangrenous eschar 
coming in contact with the bronchial and pulmonary mucous membrane, inas¬ 
much as in all probability the disease extends from the bronchi to the lung tissue. 
The foregoing description of gangrene as it occurs in the upper lobes is sufficient 
to render this form intelligible, as well as to explain why there is no inflamma¬ 
tory reaction, and consequently no line of demarcation around the affected tissue. 
This form of gangrene very often follows as a sequel to fibrinous pneumonia. 
Circumscribed or partial gangrene of the lungs appears in the form of gan¬ 
grenous eschar, and is more frequent than the former variety. "We find the 
parenchyma at some spot of varying size converted into a blackish or brownish 
green, hard but moist eschar, which adheres to the surrounding tissues, and 
evolving the peculiar odor of sphaclus, and similar to the eschar produced on the 
skin by nitrate of silver. It is sharply defined, and becomes gradually loosened 
from the surrounding tissues, and rests in a cavity corresponding to it in size and 
form. It may be described as a blackish green plug, which is soft on the sur¬ 
face,with a firm center floating in an ichorous fluid. More frequently the greater 
portion of the eschar softens and becomes dissolved into a greenish brown foetid 
ichorous pulp, mixed with rotten, shaggy fragments of tissue, and enclosed in a 
cavity, whose walls are lined by a shaggy tissue, infiltrated with ichor. 
These eschars may either occur singly, or several may be present. If the 
gangrenous eschar becomes detached it falls into the cavity of the thorax unless 
there be firm adhesions at the spot, or else it becomes dissolved, and the ichorous 
semi-solid matter is effused into the pleural sac, and gives rise to pleurisy with 
ichorous exudation, and to pneumathorax, since the foetid gas evolved from the 
gangrenous mass either collects alone in the thorax, or atmospheric air finds its 
way out through the bronchial tubes which opens into the abscess, and thus 
mixes with the aforesaid gas in the thorax. Partial gangrene often arises in the 
