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BURNS AND SCALDS

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Originally appearing in Volume V04, Page 861 of the 1911 Encyclopedia Britannica.

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BURNS AND SCALDS . A See also:

BURN, RICHARD (1709-1785)

burn is the effect of dry See also:

HEAT (0. E. haktu, which like " hot," Old Eng. hat, is from the Teutonic type haita, hit, to be hot; cf. Ger. hitze, heiss; Dutch, hitte, heet, &c.)

heat applied to some See also:

PART

part of the human See also:

BODY

body, a See also:

SCALD

scald being the result of moist heat. Clinically there is no distinction between the two, and their See also:

CLASSIFICATION (Lat. classis, a class, probably from the root cal-, cla-, as in Gr. icaMce, clamor)

classification and treatment are identical. In See also:

DUPUYTREN, GUILLAUME, BARON (1777-1835)

Dupuytren's classification, now most generally accepted, burns are divided into six classes according to the severest part of the See also:

LESION (through Fr. from Lat. laesio, injury, laedere, to hurt)

lesion. Bums of the first degree are characterized by severe See also:

pain, redness of the skin, a certain amount of swelling that soon passes, and later exfoliation of the skin. Burns of the second degree show vesicles (small blisters) scattered over the inflamed See also:

AREA

area, and containing a clear, yellowish fluid. Beneath the vesicle the highly sensitive papillae of the skin are exposed. Burns of this degree leave no scar, but often produce a permanent discoloration. In burns of the third degree, there is a partial destruction of the true skin, leaving sloughs of a yellowish or See also:

black See also:

COLOUR (Lat. color, connected with celare, to hide, the root meaning, therefore, being that of a covering)

colour. The pain is at first intense, but passes off on about the second See also:

day to return again at the end of a See also:

WEEK (from A.S. wicu, Germanic *wikon, probably=change, turn)

week, when the sloughs See also:

SEPARATE

separate, exposing the sensitive See also:

NERVE (Lat. nervus, Gr. vevpov, a bowstring)

nerve filaments of the underlying skin. This results in a slightly depressed cicatrix, which happily, however, shows but slight tendency to contraction. Burns of the See also:

FOURTH

fourth degree, which follow the prolonged application of any See also:

FORM (Lat. forma)

form of intense heat, involve the See also:

TOTAL

total destruction of the true skin.

The pain is much less severe than in the preceding class, since the nerve endings have been totally destroyed. The results, however, are far more serious, and the healing See also:

PROCESS

process takes See also:

PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place only very slowly on See also:

account of the destruction of the skin glands. As a result, deep puckered scars are formed, which show See also:

GREAT

great tendency to See also:

contract, and where these are situated on See also:

FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face, See also:

NECK (O. Eng. hnecca; the word appears in many Teutonic languages; cf. Dutch ride, Ger. Nacken; in O. E. the common word was heals; cf. Ger. Hals)

neck or See also:

JOINTS

joints the resulting deformity and loss of See also:

FUNCTION

function may be extremely serious. In burns of the fifth degree the underlying muscles are more or less destroyed, and in those of the See also:

SIXTH

sixth the bones are also charred. Examples of the last two classes are mainly provided by epileptics who fall into a See also:

FIRE (in O. Eng. f j'r; the word is common to West German languages, cf. Dutch vuur, Ger. Feuer; the pre-Teutonic form is seen in Sanskrit pu, pavaka, and Gr. irup; the ultimate origin is usually taken to be a root meaning to purify, cf. Lat. purus)

fire during a See also:

fit. The clinical See also:

HISTORY

history of a severe burn can be divided into three periods. The first See also:

period lasts from 36 to 48 See also:

HOURS, CANONICAL

hours, during which See also:

time the patient lies in a See also:

CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition of profound See also:

SHOCK, or COLLAPSE

shock, and consequently feels little or no pain. If See also:

DEATH

death results from shock, See also:

COMA (Gr. K(.7)

coma first supervenes, which deepens steadily until the end comes. The second period begins when the effects of shock pass, and continues until the See also:

SLOUGH

slough separates, this usually taking from seven to fourteen days. Considerable See also:

FEVER (Lat. febris, connected with fervere, to burn)

fever is See also:

PRESENT

present, and the tendency to every See also:

KIND (O. E. ge-cynde, from the same root as is seen in " kin," supra)

kind of complication is very great. See also:

BRONCHITIS

Bronchitis, See also:

PNEUMONIA (Gr. ?rveu AMP, lung)

pneumonia, See also:

PLEURISY, or PLEURITIS (Gr. srXeiipc =ribs)

pleurisy, See also:

MENINGITIS (from Gr. z veyE, a membrane)

meningitis, intestinal See also:

CATARRH (from the Gr. Karappeiv, to flow down)

catarrh, and even ulceration of the duodenum, have all been recorded. Hence both See also:

NURSING

nursing and medical attendance must be very See also:

close during this time.

It is probable that these complications are all the result of septic infection and absorption, and since the See also:

MODERN

modern antiseptic treatment of burns they have become much less See also:

COMMON

common. The third period is prolonged until recovery takes place. Death may result from septic absorption, or from the See also:

WOUND (O. Eng. wund,connected with a Teutonic verb, meaning to strive, fight, suffer, seen in O. Eng. winnan, whence Eng. " win ")

wound becoming infected with some organism, as See also:

TETANUS (from Gr. rei:vw, I stretch, on account of the tension of the fibres of the affected muscles), or LOCKJAW

tetanus, See also:

ERYSIPELAS

erysipelas, &c. The See also:

PROGNOSIS (Gr. apayvcooas, knowledge of recognition before-hand, from 'IrpoycyvwaKEtP, to know beforehand, cf. " prognostication," prediction)

prognosis depends chiefly on the extent of skin involved, death almost invariably resulting when one-third of the total area of the body is affected, however superficially. Of secondary but still See also:

GRAVE

grave importance is the position of the burn, that over a serous cavity making the future more doubtful than one on a See also:

LIMB

limb. Also it must be remembered that See also:

CHILDREN, LAW RELATING TO

children very easily succumb to shock. In treating a patient the condition of shock must be attended to first, since from it arises the See also:

PRIMARY

primary danger. The sufferer must be wrapped immediately in hot blankets, and See also:

BRANDY

brandy given by the mouth or in an enema, while See also:

ETHER, (C2H5)2O

ether can be injected hypodermically. If the See also:

PULSE

pulse is very See also:

BAD, BCD

bad a saline infusion must be administered. The clothes can then be removed and the burnt surfaces thoroughly cleansed with a very mild antiseptic, a weak See also:

SOLUTION (from Lat. solvere, to loosen, dissolve)

solution of lysol acting very well. If there are blisters these must be opened and the contained effusion allowed to See also:

ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape. Some surgeons leave them at this See also:

STAGE (Fr. 6/age; from Lat. stare, to stand)

stage, but others prefer to remove the raised epithelium.

When thoroughly cleansed, the wound is irrigated with sterilized saline solution and a dressing subsequently applied. For the more superficial lesions by far the best results are obtained from the application of See also:

GAUZE

gauze soaked in picric See also:

ACID (from the Lat. root ac-, sharp; acere, to be sour)

acid solution and lightly wrung out, being covered with a large antiseptic See also:

WOOL, WORSTED AND WOOLLEN MANUFACTURES

wool See also:

pad and kept in position by a bandage. Picric acid 12 drams, See also:

ABSOLUTE (Lat. absolvere, to loose, set free)

absolute See also:

ALCOHOL

alcohol 3 oz., and distilled See also:

WATER

water 40 oz., make a See also:

GOOD, JOHN MASON (1764-1827)

good lotion. All being well, this need only be changed about twice a week. The various kinds of oil once so greatly advocated in treating burns are now largely abandoned since they have no antiseptic properties. The deeper burns can only be attended to by a surgeon, whose aim will be first to bring septic absorption to a minimum, and later to hasten the healing process. Skin grafting has great value after extensive burns, not because it hastens healing, which it probably does not do, but because it has a marked See also:

INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence in lessening cicatricial contraction. When a limb is hopelessly charred, amputation is the only course.

End of Article: BURNS AND SCALDS

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