A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin.

  • Winckel, F. (Franz), 1837-1912.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin. Source: Wellcome Collection.

    71/784 (page 59)
    soon has a grayish-green color; vesicles are formed, the color then changes to a dark brown, sloughing and finally extensive loss of substance occur. In this form, it is an occasional com- plication of measles, smallpox, scarlet fever, typhus and ery- sipelas. AVest saw three cases in twenty years. I have never seen a case of this kind, but have frequently seen gangrene of the vulva follow the rupture of a large hematoma, or severe infectious cases during the puerperal state, and in renal and cardiac diseases in which the vulva was so necrosed from great oedema that gangrene supervened after labor.* I have also seen post-mortem, in the case of a girl eighteen years old, who died from typhus fever, large gangrenous ulcers which began in the right nympha, and had extended into the vagina as far as the vaginal portion. In these severe infectious diseases there is high fever, as a rule, though it may be slight or entirely absent. As to the time of its appearance, gangrene has been divided into primary and secon- dary. As to origin and course, primary gangrene is divided into three forms: a. Serous, putrid infiltration, followed by erythema and degeneration of the tissues; b. Herpetic vesicles and blebs with rapidly extending ulceration; c. Livid swelling or oedema and early breaking down. This classification appears to me to be too artificial. The airi ctiou usually terminates in death from septicaemia or pulnionary embolism. The middle cerebral artery may also be plugged. If recovery occur, cicatrization takes place in three or four weeks. About one case of noma and gangrene is seen in 1500 sick children, who are usually inmates of foundling asylums, un- healthy hospitals, or in epidemics of scarlet fever, typhus, or measles. It seems worthy of remark that, in my own experience, I have seen but one case of diphtheritis, and no case of noma of the vulva, for, if the course of labor has any influence in pro- ducing these affections, they must certainly have occurred much more frequently, considering the great number of pelvic present- ations which have come under my notice. Treatment.—The general condition should first receive * Path. d. Woch., iii Aufl., Krankengeschichte, No, 113.