DOI: 10.7925/drs1.ucdlib_280759
title: Gangraena senilis

description: Watercolour medical illustration depicting gangraena senilis. It has the alternative reference number 1275, P1B and 16? on the front. There is no Richmond Hospital Museum reference. The artist's name is in the bottom right corner 'J. Connolly Del.t'. The handwritten note under the illustration reads 'Gangraena Senilis'. The full typescript note on the back reads '7. Gangraena senilis'.
description: Scope and content: The full typescript note on the back reads '7. Gangraena senilis – Mr Carmichael produced several specimens and drawings illustrating a case of disease with which he believed that all present were already well acquainted, but which he considered in this instance to exhibit some interesting circumstances. The disease is described under various names, - Pott's mortification; dry gangrene; and gangraena senilis. The patient in this case was a gentleman between sixty and seventy years of age, subject to gout, who had lived well and enjoyed every comfort, and to whom Mr Carmichael was called during November, 1844. The disease had commenced as a small black spot on the toe next to the great toe of the left foot, which slowly extended itself, but was not painful. Mr Carmichael examined the condition of the circulation in the affected limb, and could detect no pulsation in the femoral or even in the iliac artery of that side. He advised that the patient should be removed to Dublin, which was effected in a day or two afterwards. After his removal the disease still continued to progress: the great toe and the other toes became engaged, and the disease gradually crept up the instep and to the calf of the leg. A consultation was held with Sir P. Crampton, and Drs Cusack and Adams, but no plan of treatment was capable of controlling the disease; all that could be effected being an alleviation of the patient's sufferings, which were no becoming very great. There was much constitutional disturbance, and the pulse was irregular; but the patient asserted that his pulse had always been irregular, and Mr Carmichael remembered that on a previous occasion, about a year before, when he had attended him, he observed this character of the pulse; and at the same time there was a numbness of the toes of the right foot, which made Mr Carmichael apprehensive that paralysis might be impending. After the leg became affected by the gangrene, there was very frequent delirium, constant anxiety, and complaining; and for three days before death, which occurred two days since, there was a continual gasping for breath. The gangrene did not reach as far as the knee, but before death took place it was observed that no pulsation could be felt in the femoral artery of the opposite limb. The examination of the body was made yesterday: the heart was fatty and softened, and the aortic valves were slightly ossified. The liver was pale, or rather ash-coloured. On opening the left iliac artery, fibrine was found deposited in it, and pus had formed in one portion of it; the femoral artery was plugged up in the same manner. At the opposite side, the femoral artery was similarly obstructed. Some of this fibrine was white, some tinged by the colouring matter of the blood. The left iliac saphena and the renal veins contained coagulated lymph…'.
description: Numbering/sequence: Original reference number: 1275.