By these means, even after a small quantity of matter is formed in
the gland or tumor, we may discuss the tumor, or make it less; but,
if the quantity of matter should continue to augment, we may consider
resolution as out of the question. Our object must then be to bring
the part to suppuration as quickly as possible; because we not only
thus shorten a process which must be completed before the parts can be
healed, but also render the ulcerative action more healthy, and easier
induced; for the more quickly that the suppurative action is performed,
the sooner does the ulcerative action take place, and the more vigorous
is it, provided that no new cause render it unhealthy, as has formerly
been mentioned.
This advice, however, must not be adopted without some exceptions, and
must be chiefly confined to affections of the glands and cellular
substance, and ought not to be extended to the joints. In these
cases, even although a small quantity of matter form, we ought still
to endeavour to prevent general suppuration, and the bursting of an
abscess; because this would, instead of accelerating the cure, as is
frequently the effect in the other case, be attended with dangerous
consequences; we must therefore rather continue the use of the issues,
and endeavour to procure the absorption of what matter is already
formed.
The means employed for promoting suppuration were formerly poultices
of lily roots, honey, &c. alternated with fomentations prepared from
pomegranate seeds, and myrrh, and cypress leaves, or, occasionally,
stimulating plasters; but now the common bread and milk poultice is
advantageously substituted in place of these remedies. When the
process is very tedious, electricity is useful along with the poultices.
When these tumors have suppurated freely, and an abscess occupies
the whole of the gland, it is useful to evacuate the matter by a
small opening with a lancet, if there be no appearance of the abscess
bursting quickly, and the sooner this is done the better. When this is
done, a poultice should be applied until next day, the part is then to
be wiped clean and dry, and a small bit of lint, spread with simple
ointment, applied on the orifice. The surrounding red skin is to be
dulled with powdered cerussa[100], and then covered with dry lint. A
compress is to be laid over the whole, and moderate pressure employed.
These applications are to be renewed every day, or twice a-day,
according to the quantity of the discharge, and other circumstances;
and, at each dressing, the parts may be bathed with spirit of wine.
If this mode of dressing does not produce a cure, but the opening
enlarges, and the surface ulcerates, we must then employ the dressings
for a scrophulous sore.
[100] Keeping this skin dry has a tendency to prevent ulceration,
and abate the redness and inflammation. The cerussa may sometimes be
advantageously mixed with an eighth part of powdered camphire, which
promotes the removal of the superficial inflammation.
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