Part 35
Sphacelus of the fleshy parts is produced by the tight compression
of bleeding wounds, and by pressure in the fractures of bones, and
by blackening, arising from bandages. And in those cases in which
a portion of the thigh or arm, both the bones and the flesh drop off,
many recover, the case being less dangerous than many others. In cases,
then, connected with fracture of the bones, the separation of the
flesh quickly takes place, but the separation of the bone, at the
boundary of its denuded part, is slower in taking place. But the parts
below the seat of the injury, and the sound portion of the body, are
to be previously taken away (for they die previously), taking care
to avoid producing pain, for
deliquium animi may occasion death. The
bone of the thigh in such a case came away on the eightieth day, but
the leg was removed on the twentieth day. The bones of the leg, in
a certain case, came away at the middle of the sixtieth
[p. 293]day. In these
cases the separation is quick or slow, according to the compression
applied by the physician. When the compression is gently applied the
bones do not drop off at all, neither are they denuded of flesh, but
the gangrene is confined in the more superficial parts. The treatment
of such cases must be undertaken; for most of them are more formidable
in appearance than in reality. The treatment should be mild, but,
not withstanding, with a restricted diet; hemorrhages and cold are
to be dreaded; the position, so as that the limb may be inclined upward,
and afterward, on account of the purulent abscess, horizontally, or
such as may suit with it. In such cases, and in mortifications, there
are usually, about the crisis, hemorrhages and crisis, hemorrhages
and violent diarrhoeas, which, however, only last for a few days;
the patients do not lose their appetite, neither are they feverish,
nor should they be put upon a reduced diet.