The diet ought to be good, in all cases of ulcers; but spiritous
liquors, and the irregularities of life, must be avoided.
In ulcers of the legs, if pressure be employed, rest is not absolutely
requisite; but, if this be not used, no cure can be obtained, if the
patient walk about. Even if the adhesive plaster be applied, we ought
not to allow of so much motion as to produce fatigue, or any uneasiness
in the sore.
The treatment, then, of this genus of ulcers, may be comprised in two
aphorisms.
First, When the action is, from the first, healthy and vigorous, and
is continuing so, all which is essentially necessary, is to defend the
part, and prevent the operation of any cause which might injure the
action, such as cold, too much heat, mechanical irritation, &c. This
may be done, by applying a bit of dry lint, or a rag spread with simple
ointment, and wrapping the limb round with a flannel roller. But, if
the action begins to flag, as it often does in large ulcers, or if the
process become stationary, we must then indispensibly have recourse to
gentle pressure.
Second, When the action has, at any one period, been diseased, or too
low, but has been restored to a proper state, we must of necessity
continue gentle pressure, and treat the sore as if the action were
stationary, although it may not be so.
GENUS II.
_Of the Indolent Ulcer._
In this genus, the action is diminished, and, consequently, rendered
imperfect and diseased.
Indolent ulcers, like those of the next genus, are divisible into two
species: First, that in which both parts of the ulcerative action,
namely, the granulating and purulent, are equally diseased, and equally
imperfectly performed: Second, that in which one part is more affected
than another[49].
[49] The circumstance of one part of an ulcer being more affected than
another, will be more fully noticed in considering the next genus, in
which it is of more practical consequence. Ulcers generally belong to
this species, before they assume the characters of the second (for they
frequently change from one species, or genus, to another; in which
case, the treatment must also be changed).
The first species is distinguished by the following symptoms, which
appear in greater or less degrees, according to the diminution and
imperfection of the action.
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