The Treatment of War Wounds

Cover The Treatment of War Wounds
The Treatment of War Wounds
William W William Williams Keen
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Makins, on page 794 of his paper (loc. Cit. ), makes an interesting reference to "Hospital Gangrene, " of which, in common with all our surgeons, I saw so much during our Civil War. His description would apply fairly well to those cases, though the rapidly spreading destruction seen in our Civil War cases is not emphasized by Makins. Since then hospital gangrene has entirely disappeared. We do not even know its pathology or its bacteriology. Makins says: "One form of streptococcus infection des
...erves special mention as possibly corresponding to the va- riety of 'classical hospital gangrene' described as the membranous. Cases of this nature have not been common, although sufficiently so to have become familiar. A wound which has previously been appa- rently progressing favourably becomes covered with a dense grey tough membrane, firmly adherent to the subjacent granulations. In the earliest stage this membrane does not materially differ from the thin layer of coagulated fibrin and included leucocytes which not uncommonly forms in cases of strepto- coccic infection which after a time fail to respond to treatment.

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