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Donald E. Dial, M.D.
JAMA. 1938;110(21):1747. doi:10.1001/jama.1938.62790210004008c.
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Rees1 has called attention to the absence of reports of injuries resulting from the injection into the tissues of oil under high pressure, such as may occur in working with Diesel engines. In these engines the fuel is forced through fine jets at pressures as high as 6,000 pounds per square inch in order to produce finely divided particles for rapid combustion. At such pressures the fine spray may penetrate the skin and cause injury to the subcutaneous tissues. In the case reported by Rees the accident resulted, in twenty-four hours, in intense pain and marked swelling of the affected finger and the hand. Gangrene of the finger followed and amputation through the metacarpal bone became necessary. The cases to be reported here were similar in several respects; namely, the severe pain, the gangrene and the sterile necrosis involving the skin and especially the subcutaneous tissues.



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