Page 143 - My FlipBook

INFLAMMATION. 141
changes in nutrition, peculiar dyscrasiae, and diatheses, the rapid-
ity of the circulation, and injuries which are the most frequent
causes, especially in the aged, the feeble, and those suffering from
some constitutional diathesis, such as tuberculosis, syphilis, gout,
diabetes, etc. Common ulcers are of the mucous membrane and
skin and are never fatal except through septic infection.
Treatment.—The treatment of ulcers is both local and consti-
tutional, the cause of irritation being first removed and the inflam-
matory symptoms relieved. Rest of the affected part, cleanliness,
hot antiseptic applications, elevation of limb when an extremity
is involved. Stimulating remedies such as nitrate of silver, per-
manganate of potash, sulphate of copper, iodine, boric acid,
balsam of Peru, and ichthyol, especially in indolent ulcers, and
spraying with liquid air, are excellent. Chromic acid is useful
in secondary syphilitic ulcers. Iodine and iodoform are service-
able in tubercular ulcers. Skin-grafting and plastic flap opera-
tions are sometimes resorted to for the purpose of closing ex-
tensive ulcers ; also sponge-grafting to hasten the process of
healing. The constitutional treatment of ulcers is directed to
the systemic condition, when it is a predisposing cause, and
appropriate remedies administered for its eradication. The
strength must be supported by the use of tonics, and a vegetable
diet recommended, and also abstinence from wine and malt liquors,
etc.
Gangrene.—Gangrene signifies the mortification or death of
a part of the body, owing to failure in nutrition, and death of
soft tissue. There are two forms of gangrene—the dry or
senile, and the moist. Dry gangrene—mummification—occurs
from death of the soft tissue of parts exposed to the air, and
results from defective blood-supply owing to feebleness of the
circulation and changes in the vessels. The diseased part be-
comes engorged with blood, and the coloring matter transudes
the tissues, and the part assumes a dark red or purple appearance.
The tissues begin to dry from evaporation, and the affected part
becomes leathery, hard, and brittle, and also black ; between the
dead and sound tissues there is an inflammatory zone, or line of
demarkation. Usually there are no general constitutional symp-