Inflammatory conditions of the respiratory tract or organs are common results; pneumonia, bronchitis, and sudden congestion or œdema of the lungs are frequent (Cases 11, 15, 16).
Inflammation of the intestines, inducing peritonitis and ulcerations of the intestines with or without resulting hemorrhage, occurs as a frequent lesion (Case 10).
Gangrene or septicæmia causes death in other instances.
Exhaustion, from extensive and prolonged suppuration or from severe and long-continued pain and other conditions, terminates other cases (Case 12).
Legally, burns and scalds are included among injuries endangering life, but are not described as wounds. They may be considered dangerous according to the extent of surface which they cover, rather than the depth to which they involve the tissues.
The extensive injury to the sensory nerve structures and the suspension of function or destruction of a considerable portion of the perspiratory tracts render large superficial burns far more fatal than those confined to a small part of a limb, for example, which may be deeply burned. From a medico-legal point it is desirable to establish the fact of how large a surface must be injured to prove fatal. The effort to reduce the subject to a statement of an exact minimum area of square inches seems very objectionable and liable to lead to erroneous conclusions.
It is possible to make a general statement, subject to some qualifications, which may serve as a basis of conclusion, as each individual case must be considered in its own circumstances.
A burn involving two-thirds of the body may be regarded as necessarily fatal; but the injury of a much less proportion, even one-fourth of the surface, has resulted in death. The qualifications to be made in burns of less extent are pronounced. The part affected is of much importance. Burns of the trunk are more fatal than those of the extremities; and those of the genital organs[706] and lower part of the abdomen are especially so (Case 7).
The character of the burn, whether single and continuous or multiple and scattered over various portions of the body, is a very important modifying circumstance, involving the questions of excessive pain and the difficulty in insuring necessary treatment for all parts injured.
The physical condition of the patient and sensitiveness of the nervous system to pain exert a powerfully determining influence. Burns in children and sensitive, nervous females are specially serious and call for an unfavorable prognosis.