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LOCALIZED GAS INFECTIONS IN WAR WOUNDS TREATED BY MUSCLE GROUP EXCISION

KELLOGG SPEED, M.D.
JAMA. 1918;70(4):225-227. doi:10.1001/jama.1918.26010040003008.
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In the early part of the war, the mortality from gas infections in wounds acquired in the lowlands of France and Belgium was high. Delay in treatment, unclassified knowledge, and lack of intensive study of the early symptoms were partly responsible. When the bacteriology and pathology were investigated and their interpretation was applied to the clinical manifestations, surgeons rapidly came to differentiate between early localized gas infections and the massive invasions of whole limbs. It is my intention to set forth briefly a few of the points connected with early localized infection, and to attempt to disseminate knowledge of the value of immediate treatment.

The histologic studies of McNee and Dunn1 have shown conclusively that the spread of these infections into living muscle is extremely rapid, so that in three and one-half hours after the reception of wounds the condition is established. If the causative wound involves the main

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