A point to be noticed is that death may occur quickly, following a comparatively slight wound, when examination postmortem shows gas gangrene involv- ing buy viagra minneapolis only a small bulk of actual buy viagra minneapolis muscle tissue.
The material elaborated by the bacilli, whether it be a true toxin or not, is a powerful systemic poison. Anthony Bowlby has pointed out that cases of this kind may very readily be mistaken for death from shock alone. Wounds involving main blood vessels allow rapid de- velopment of gas gangrene in distal segments or parts.
The spread of gas gangrene into healthy, living muscle, with an intact blood supply is a less easy problem. Two factors generic viagra 50 must be brought to mind: Fresh material is generic viagra 50 absolutely essential for correct conclusive investigation as the organisms prolif- erate and produce gas rapidly in the warm body after death.
Amputated limbs and stumps left after ampu- tation afford good material generic viagra 50 for examination as anaerobic organisms are found buy viagra minneapolis in the healthy muscle at a consid- erable distance from the actual seat of the gangrene, but their presence does not constitute gas gangrene. The Bacillus aerogenes capsulatns B. By the examination of serial sections of tissue, most of the information has been obtained by the method buy viagra minneapolis of spread.
Macroscopic-ally this spread- ing margin is sometimes fairly sharp, at other times, somewhat irregular. The muscle fibers at the margin are paler and duller than the normal but the color change is little more than might be accounted for by total absence of blood in the part involved. The outer limit of the process while indefinite can be mapped out fairly closely buy viagra minneapolis if the healthy tissue beyond is still con- tractile, as this power is lost in the part becoming gan- grenous.
At the advancing edge the muscle is firmer to the touch than the healthy fibers beyond and the firm- ness is found in the gangrenous part behind. Micro- scopically in a section taken from as near as possible the advancing edge, various changes are found. Vari- ous normal fibers are seen, while others exhibit a strik- ing change. The staining reaction is different, and dots indicate the individual fibrils lost. The fibers generic viagra 50 are swollen, but are well separated from the inter- stitial connective tissue, to leave what appears to be a clear space.
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