[97] Practique Moderne de Chirurger, par Ravaton, Tom. II. p. 3.
Nitrous acid has, I believe, in some cases, a considerable power over
scrophulous ulcers. From the trials which I have made with it, I am
inclined to attribute some effect to it in promoting the suppuration
of scrophulous glands, or tumors, and in disposing ulcers to heal. Two
or three drachms may be given daily, and continued for a fortnight,
provided no bad effect be produced by it, such as pulmonic affections,
&c. If, within this time, no melioration appear, we may give up this
medicine.
The hepatised ammonia, in the dose of eight or ten drops, three times
a-day, is sometimes useful in abating the pain, and changing the fiery
appearance of the irritable ulcer, or struma maligna.
The breathing of oxygene has been proposed as a cure for this species
of inflammation; but it will be extremely difficult for the advocates
of pneumatic medicine to point out any authentic case in which it was
really of benefit.
Much has been written concerning the local treatment of scrophulous
tumors and ulcers; but we are still very much in the dark with respect
to any efficacious method. Formerly, the extirpation of the gland, or
tumor, was advised by all; but, more lately, doubts have been started
concerning the propriety of the practice; and, by most practitioners,
it is now deemed unnecessary, if not dangerous.
In the writings of the ancients, as well as many of the older
writers on surgery in our own country, particularly in the works
of Mr. Wiseman, this practice is freely inculcated; and many cases
are detailed in which the tumor was extirpated with success. Even
in the present day, no surgeon dreads the consequence of removing
scrophulous joints, which, with regard to the present question, are to
be considered in the same light with the glands.
It is supposed, that, by extirpating superficial tumors, the disease
may be transferred to some of the more noble parts, and produce a more
fatal complaint. But, if it be admitted that these tumors do not appear
as necessary parts of scrophula, as the eruption of measles does of the
rubeolous fever, but only as accidental circumstances, or fortuitous
inflammations, rendered tedious and specific by the peculiarity of
the constitution, this supposition will appear to be groundless.
Even granting that scrophulous tumors did appear without any local
exciting cause, and were, in every respect, similar to the eruption of
exanthematous fevers, it will not thence follow, that removing the
local disease, after it has appeared, will make another part become
diseased; unless it be said that scrophula depends upon a particular
morbid humour, which, if denied an outlet in one place, must accumulate
in another, which is a supposition I will not trouble myself to refute.
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