Different degrees of injury are inflicted on the surface from the
application of heated solids or fluids. The term scald is generally
confined to the effects of heated fluids, whilst burn denotes the
consequences of the application of a heated solid, or of ignited
combustible matter; the latter class of accidents is, in general, the
more serious, yet the former, though not injuring the skin deeply,
gives rise to the most alarming symptoms when a large extent of surface
is affected. A slight degree of heat is productive only of redness of
the surface, with a sharp hot pain, and these symptoms may subside with
or without vesication. However, effusion of serum under the cuticle
often takes place almost immediately after the contact of the heated
body—the cuticle may be destroyed by the intensity of the injury—or the
true skin may die, either partially or throughout its whole thickness,
and the subjacent parts be at the same time injured to a greater or
less depth. But parts, not severely injured at first, may afterwards
perish, violent inflammatory action being excited, which terminates in
sloughing. The neighbouring parts have their vitality much diminished,
by the direct influence of the injury; and hence, when these parts
come to be the seat of increased action, sloughing almost inevitably
ensues, from the want of corresponding power. From the same cause,
subsequent sores are tedious in healing, being so far debilitated as
to be unable to assume full vigour; even slight ulcerations following
vesication contract very slowly; the granulations are flabby, and the
discharge profuse and thin. The inflammation is often at first very
violent, and kept within bounds with difficulty. Burns of the trunk,
particularly of the genital organs, are to be considered as attended
with much danger. And extensive burns and scalds, wherever situated,
are always to be dreaded. Violent constitutional irritation takes
place, dyspnœa is apt to occur, with effusion into the chest of serum,
or a sero-purulent fluid; and the nervous system ultimately becomes
oppressed. Great sinking of the vital powers is generally the immediate
consequence of extensive and severe burns; there is shivering, weakness
of the pulse, cold extremities, anxiety, and vomiting, requiring the
exhibition of warm drinks, and even sometimes of cordials, opium, or
strong stimulants. These must, however, be given with a sparing hand,
or the depression following the excitement is with difficulty got over.
Nor can it be matter of surprise that such serious effects occur, when
we reflect on the extreme sensibility, and highly organised state of
the affected part, and the important functions which it is intended
to perform, as well as those sympathies which it holds with internal
parts, on which life principally depends.
Public-domain text, read in full here on John Shaqi.
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