Selected monographs.

  • New Sydenham Society.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    phenomenon. But the basis of them always rests on the same doctrine. The more we reflect on this definition, the more unsatisfactory or even erroneous we find it. It is insufficient, because it explains neither the appearance nor the mode of evolu- tion of gangrene. It is erroneous, because we assume thus a term of comparison which is far from being always exact. I go into an amphitheatre and detach there a limb of a corpse ; everybody will admit that the limb is dead, and yet it is very certain that it is not, and has never been gangrenous. To say that gangrene is a partial death is in truth to say nothing at all, and to content oneself with mere words. If we understand thereby that a part more or less extensive ceases to belong to the organism, this definition will apply to conditions which have nothing in com- mon with what is generally designated by gangrene. And it will be necessary at once to include all those morbid states to which have been given in Germany the name of necrobiotic processes, a somewhat bizarre term, which means simply an interstitial process tending to the more or less complete destruc- tion of the histological elements of a tissue. Further, may not the purulent disintegration of a living part, from one point of view be regarded as a partial death ? And without even leaving the domain of physiology, may we not consider that the epithelial desquamation which takes place incessantly on the surface of the skin and of the mucous membranes has for its normal tendency the elimination of a certain number of elements which have belonged to the organism, and which cease to belong to it ? It is sufficient to consider attentively a limb affected with dry gangrene to be convinced that there must have occurred something very special; the shrivelling up of the tissues, the horny aspect, the woody hardness, the ebony black colour, give to the skin, the aspect of an Egyptian mummy or of a piece of gutta percha. It is impossible that these characters should have been produced all at once, and we must assume the intervention of one of the most complex of pathological pro- cesses.* There are only two alternatives : either the simple fact of the removal of a limb from the influence of vital forces may * The definition of the Compendium cle Chirwgie, written in this spirit, appears to me the only one which approaches the truth. Vide T. iv., p. 236.