Gangrene, an intense degree of inflammation; in which the part affected grows livid, soft, little sensible, and is frequently covered with vesicles contain ichorous matter. But, when the part becomes blackish, flaccid, easily lace-rable, cold, insensible, and emits the smell of putrid flesh, so that the corruption quickly spreads, it is then called sphacelus.
Persons of a good habit of body are seldom affected by a gangrene; though, even in them, it may accidentally be induced by contusion, long-continued pressure, or by whatever destroys the texture of a part, and deprives it of its nourishment. Thus, in cold climates, severe frosts frequently occasion this malady, by impeding the circula-tion.—In rheumatic constitutions, especially those advanced in years, the feet are first afflicted with pain, while on the inner side of the small toes, livid spots appear, from which the skin scon separates. By degrees the foot sweils, and the toes become mortified.
As soon as there is reason to apprehend, from the unnatural heat of the part affected, and the violence of the fever, that a gangrene will ensue, the patient ought, without loss of time, to apply for professional advice, as bleeding may perhaps be useful: meanwhile, hi* diet and other treatment should be similar to that prescribed under the head of Inflammation.
When an inflamed surface assumes a gangrenous appearance, while the patient is weak, and the pulse low, it will be advisable to resort to a nourishing diet, together with the free use of generous wine, and whatever else is calculated to invigorate the system. Peruvian bark in powder is usually given, in as large quantities as the patient's stomach can support. According to later experience, however, musk conjoined with the volatile salt, of amber, affords a still more powerful remedy, for cheeking the progress of gangrene : eightgrainsof the former, with five of the latter, have been administered in the form of pills, every three hours, with evident success, after the bark and valerian had been given without effect.
In gangrenes arising from intense frost, the parts ought to be immersed in very cold water, or rubbed with snow; for warm ap-plications will be attended with speedy mortification. A similar practice should be adopted, if" the whole body has become torpid, or rigid, from the severity of the weather ; but, in this case, the water ought to be gradually changed for some of a warmer temperature.— Frictions with salt will also be of considerable service; and, it the whole body be benumbed, it will be requisite to administer first a glass of cold wine, or other cordial, and afterwards some warm wine, either alone or with spices.
It, however, in quently happens, that a mortification takes place, though no efforts or attention be neglected. in such unfortunate situation, we can by no means approve of extravagantly cutting and dissecting the parts, as soon as they appear gangrenous) but, where the
: extends very deep, it will be beneficial to scarify the diseased spots, and to remove part of the putrid muscular fibre.
Various external applications have been recommended, as auxi-lary means of curing a gangrene ; but the following deserve particular notice : Dr. HaHNEMAN has, with singular success, employed a strong decoction of oak-bark, name-:ix ounces of it, in coarse pow-der, boiled in a quart of water till it is reduced to one pint: four or double rags are dipped in it, and applied in a cold state to the diseased part, every half hour, but the compress must every time be made of clean rags. - Others have, with equally good effect, resorted to gentle stimulants; generally consisting of a weak solution made of dram of sal-ammoniac in two ounces of vinegar, and six of water: the degree of stimulus may be increased, or diminished, by varying the proportions of the salt.
Lastly, when a separation of the mortified part, and a discharge of the corrupt matter, have been effected, either by the use of external or internal remedies, the remaining sore is to be treated as a simple purulent ulcer, and may be healed in the same manner.