A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
the exuberant gums, or, becoming gradually loosened from the alveoli,
finally drop out. The morbid process may extend to the bone itself, and
necrosis and extensive {178} exfoliation follow. Mastication is more or
less painful, and often impossible, so that the patient is reduced to
the necessity of prolonging life by the use of fluid or semi-solid
food. Under the influence of appropriate treatment it is remarkable how
rapidly (in from two to four weeks) these marked changes recede and the
parts resume their normal condition, yet it occasionally occurs that
permanent, callous thickening of the gums results.
[Footnote 13: _Étude sur le Scorbut_, 1871.]
[Footnote 14: _Une épidémie de Scorbut_, p. 28, 1872.]
In the progress of the disease effusions of blood under the skin are of
early occurrence. They are at first located in the superficial stratum
of the cutis or just beneath the epidermis, especially around the roots
of the hair, and present themselves as roundish, bluish-red flecks,
varying in size from that of a pin's head to that of a split pea, not
effaceable by pressure with the tip of the finger, but slightly, if at
all, elevated above the surface, and enduring for weeks together. The
nutrition of the hair-follicles is impaired, so that the hairs are
often either lost, broken, or distorted. These petechiæ fade in color
with progressive improvement in the case, and finally disappear,
leaving brownish-yellow discolorations. They first appear on the
extremities, particularly the lower limbs, then on the face, and lastly
on the trunk. At a later period extravasations of a larger size and
more irregular form occur in the deeper layers of the derma. They vary
in size from that of a finger-nail to blotches two or three inches in
diameter; at first reddish in color and subsequently of a bluish red.
When recession occurs under appropriate treatment, the color passes
through various shades of violet, blue, green, and yellow, as in
ordinary traumatic ecchymosis. Outpourings of blood also occur into the
subcutaneous connective tissue, notably that of the legs, and in
localities where connective tissue is particularly abundant and loose,
as in the ham and axilla. The dispersion of blood in this tissue may be
so considerable as to cause the legs from the knees down to present a
uniform dark-blue coloration that in form may not inaptly be compared
to a stocking. The upper extremities also suffer, usually on their
inner side from the armpit down, the extravasation rarely reaching,
however, to the hand. These extravasations may take place after the
infliction of very slight injuries, as from blows or the pressure of
hard bodies, or even from the mechanical effects of prolonged
dependency of the limbs, as in riding on horseback. Extravasations of a
similar nature are occasionally present in the connective tissues of
the muscles themselves or between them, giving rise to swellings of
various forms and dimensions. Nearly always along with the sanguineous
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