The x-ray per se is incapable of injur ing the tissues of the patient, and the dermatitis, which has been called an x ray "burn," is the result of an interfer ence with the nutrition of the part by the induced static charges.
The patient may be absolutely pro tected from the harmful effects of this static charge by the interposition between the tube and the patient of a grounded sheet of conducting material that is readily penetrable by the x-ray, a thin sheet of aluminium or gold-leaf spread upon card-board making an effectual shield. C. L. Leonard (N. Y. Med. Jour., July 2, '98).
Burns of Mucous Surfaces.—The mu cous surfaces may be affected by the in halation of flames, vapors (volatile or boiling acids), boiling liquids (water, slacked lime), and by certain substances acting directly, such as ammonia and sulphuric and hydrochloric acids. The mouth, pharynx, larynx, bronchi, and the oesophagus, as well as the stomach, share in the attack. The eye often, from its exposed position, is the seat of burn. Conjunctivitis often results from irritants coming into direct contact with the eye, and if the exciting agent is not soon removed great destruction of sub stance or sight may be the result. CONSTITUTIONAL EFFECTS.—The ef fects of burns of the first degree upon the system are generally slight and are limited to pain, which disappears shortly after the removal of the exciting agent, but often may last for several hours.
In burns of the second degree the pain accompanies the phenomena not alone for hours and days, but often for weeks and even months. The shock may be of a transient character or of an alarming intensity. It may be encountered at the time of accident or be delayed for ods varying from hours to days there after. When small areas are involved, the depression may soon be relieved, but when one-fourth or one-third of the body is attacked death may intervene.
Burns of the third degree may be so severe that death intervenes before pain has time to appear. Shock at this stage is therefore observed early and of the worst character. Early mortality is gen erally due to the shock, while late mor tality usually occurs during the stage of suppuration. Vomiting is often ob served in both the second and third de grees.
Children suffer more from burns do adults, and women more severely than men. The temperature is not af
fected by burns of the first degree, but is a marked symptom in those of the second and third. At the time of acci dent it may decrease from one to three degrees below the normal (to 97° or even 95°) and remain at that pbint until reaction begins, which is in about 36 or 4S hours, when it rises during the next 12 to 18 hours to 104° or 106° or more, at which point it remains for a period of 8 to 10 days (possibly rising and low ering at irregular intervals), when gran now in a fair formation, act as a retarding agent.
Complications.—The after-effects of burns may be concentrated upon the vis cera (neural, thoracic, and ventral cavi ties) or directly upon the part affected (cicatrices, contractions, and fractures of bone). Burns of the first degree remain uncomplicated, while those of the second and third present many variations. The meninges (arachnitis following burns of the head), as well as the brain proper, may become congested or even highly inflamed, the sufferer presenting all the symptoms of restlessness and delirium, ending either in convulsions or coma. Tetanus is an early complication ob served. Bronchitis and pneumonia often result either from inhalations or indi rectly from surface burns. Congestion in the kidney has been noted, with re sulting albuminuria or hmmoglobinuria, while in many cases the urine becomes exceedingly scanty. Autopsies have shown rupture of the diaphragm and stomach, accompanied by contraction of the bladder. Amyloid degeneration in the viscera has been noted after pro longed suppuration. Inflammation of the gastro-intestinal tract with the for mation of an ulcer (usually one, but more rarely several) of the duodenum (at its pyloric end) frequently occurs. This ulceration may begin early (four or five days) or it may be delayed for weeks, although, without the appearance of rec tal hemorrhage or perforation, with con sequent peritonitis, we have no means of determining its presence. At times this inflammation extends to the colon and causes diarrhoea. Burns affecting either the chest or abdomen are the inducing cause, although severe burns at other points may produce them. Septicemia, pymiia, or erysipelas (the streptococci being found after death in the blood) may be the fatal ending.