Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


#Gangrene from Frost-bite.#--It is difficult to draw the line between
the third degree of chilblain and the milder forms of true frost-bite;
the difference is merely one of degree. Frost-bite affects chiefly the
toes and fingers--especially the great toe and the little finger--the
ears, and the nose. In this country it is seldom seen except in members
of the tramp class, who, in addition to being exposed to cold by
sleeping in the open air, are ill-fed and generally debilitated. The
condition usually manifests itself after the parts, having been
subjected to extreme cold, are brought into warm surroundings. The first
symptom is numbness in the part, followed by a sense of weight,
tingling, and finally by complete loss of sensation. The part attacked
becomes white and bleached-looking, feels icy cold, and is insensitive
to touch. Either immediately, or, it may be, not for several days, it
becomes discoloured and swollen, and finally contracts and shrivels.
Above the dead area the limb may be the seat of excruciating pain. The
dead portion is cast off, as in other forms of dry gangrene, by the
formation of a line of demarcation.

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