The second species exists in various degrees, and its symptoms admit
of modification from the previous state of the ulcer. Sometimes an
ulcer, although previously healthy, has its surface excited into a
state of overaction, by exercise, or other causes. In this case,
the sore becomes painful, and the granulations assume first a kind
of light crimson colour, and then a brownish hue, from a species of
mortification. They do not indeed become gangrenous, and slough, but
they approach to a state nearly resembling death, and are absorbed.
The edges are slightly erysipelatous, and the discharge watery. This
may be called the first degree or stage of the disease; and the
ulcer frequently recovers soon from this, and reassumes its healthy
condition. But if it be neglected, or the injuring causes still
continue, the state of overaction is increased, and becomes more
perfect[58]; that is to say, the action which was injured in its
different parts, and rendered unconnected by the incipient or new
condition, becomes more completely and connectedly performed in its
different parts, in an increased degree. The overacting state, which,
in the first stage, took place, perhaps only for a few hours, or at
least if it continued, did not rise to any great degree, or receive
an augmentation in this stage, continues with violence, and generally
with exacerbation. The granulations are absorbed almost as soon as
they are deposited; because, owing to the overaction of the part, they
are very imperfectly organised, and possess very little life and power
of supporting action[59]. They evidently appear to be in a state of
overaction; for they are fiery, and their colour, whether it be red or
brownish, is bright or clear, and quite opposite to the dull hue which
even the same colour may have in a different kind of sore. These bleed
upon the slightest touch; on which account, the discharge is generally
bloody. The margins are red and ragged, as if they were bitten by a
mouse; and they are evidently in an ulcerating state. The surrounding
skin is hot and erysipelatous, the discharge is thin and serous, and
the pain great, generally somewhat of the burning kind. This sore,
from the destruction of the granulations, and the propagation of a
morbid degree of action, spreads as long as this condition continues;
but the progress, as long as the ulcer belongs to this genus, or as
granulations are formed, is not very rapid.
[58] By this I mean more perfect in its state of overaction.
[59] In highly overacting ulcers, the granulations seem to possess
a middle state, betwixt proper organic particles and the morbid
substance, called pus.
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