Mild ointments, such as the simple cerate, are frequently employed; but
they must be free from all rancidity, otherwise they fret the skin, or
injure the sore. In general, they are less useful than dry lint. When
we do employ them, they ought to be applied only to the granulations
and cicatrix, and not to the sound skin. More frequently we use these
ointments spread on a pledget of linen, to keep the dry lint on the
sore.
Poultices are also recommended in these cases; but they possess no
peculiar advantage, and are apt to make the part feeble, and more
likely to break out again.
Moderate pressure, by keeping up the action, is generally of service;
but it is still more necessary when the action begins to flag, or
becomes stationary. In this case, a compress ought to be placed
over the sore, and the whole member rolled firmly round with a
cotton bandage or, what will be still more useful, the part should
be encircled with strips, spread with adhesive plaster, in the way
which will afterwards be mentioned. Pressure acts by taking away the
condition of vacuity; it forms an artificial covering and interstices
for the superficial granulations, by which the natural process of
forming granulation and skin is greatly assisted. The parts are, in
this way, not only more quickly formed, but also in greater perfection;
and their powers of action are greater. The cure is therefore more
permanent, and the part is not so apt to die, or ulcerate again, as
when healed with simple dressings.
This practice, which is useful in ulcers which from the first are
healthy, is still more necessary in curing those which were formerly
diseased, but have now become healthy; because, in them, the action is
still more apt to flag.
The healing of large healthy ulcers which succeed to wounds, &c.
will also be much hastened, if we artificially diminish the size of
the cavity, and procure contact. Whenever one part can be brought in
contact with another, it ought to be done, if the figure and functions
of the part be not thereby injured, or if pain be not produced by doing
so.
The older authors, from a mistaken theory, never allowed the action
to proceed uninterrupted, or never co-operated with it in a rational
manner. In every ulcer, it was necessary, first, to digest, or
suppurate it, which was done with turpentine, or basilicon; next it was
to be deterged with turpentine, mixed with yolk of eggs, or by the red
precipitate; then it was to be incarned by sarcotics, such as tincture
of myrrh and aloes, balsam of Peru, frankincense, &c.; lastly, the
surface was to be dried into a callus, with dragon’s blood, white-lead,
chalk, &c. These plans have, however, been long laid aside; but some
practitioners still advise the use of styptics and spirit of wine to
produce a cicatrix; they forget, however, that skin is formed by a
different process than corrugation.
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