When the state of overaction becomes confirmed, and progressive, the
sore spreads, becomes very painful, and assumes the appearances which
have been already described. In this case, the application of carrot,
or turnip poultices, is frequently useful. These vegetables are
sometimes made into a poultice by boiling them, and, at other times, by
rasping them down raw.
Camomile flowers, boiled in milk, and then expressed, yield a
decoction, which, when made into a poultice with crumb of bread,
frequently abates the pain. Sometimes the application of cloths, dipped
in fine oil, give relief.
These sores are also frequently reduced to a more healthy state, by
applying cloths dipped in the following mixture:
R. Ammon. Hepatizatæ[63] guttas decem.
Aq. Font. uncias octo.
[63] The ammonia hepatizata is prepared by passing a stream of hepatic
gas through the aqua ammoniæ.
This produces a moderate degree of smarting for a little time, during
which the former painful sensation arising from the sore lessens, and
does not return for some time. When the peculiar pain of the ulcer
again manifests itself, the solution is again to be applied.
An ointment, consisting of two drachms of powdered opium, and one ounce
of simple cerate, is also a very useful application.
Sprinkling the sore with red precipitate, or touching the surface with
caustic, frequently stops the disease.
The kind of erythematous affection, which frequently affects the
surrounding skin, is best removed by stimulating applications, which
abate the pain or hot sensation, and make it less apt to ulcerate. The
following is a very useful application for this purpose. The affected
part is to be lightly dusted with it occasionally:
R. Hyd. Precip. Rub. unc. i.
Pulv. Opii semiunc.
Cretæ Ppt. unc. ii. Tere simul ut fiat pulvis subtiliss.
When, by any of these applications, the state of overaction is
overcome, pressure is the best remedy for preserving our ground, and
producing a cure; for, remedies which may be useful in the diseased
state, will be hurtful when this state is removed.
In this sore, anodynes are to be freely employed internally; for, given
sparingly, they do no good[64].
All the applications ought to be made gently, and lightly; because any
mechanical irritation increases the disease.
[64] No external application whatever will produce the same good
effect, if used by itself, as when such a general action is induced as
shall co-operate with the local remedies. In slight cases, thirty drops
of laudanum may be given twice a-day; but, when the overaction is more
violent, the dose must be more frequently repeated.
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