In the second division, the fermenting poultice[67] is often of
service; but it must, like all other applications, be continued no
longer than the state which it was intended to remove remains. If
we continue it too long, we do hurt; for, if it be kept on when it
produces continued pain, it induces a state of overaction, similar to
that which it was intended to destroy. Whenever the surface becomes
redder, and the pain less, it may be useful to employ some other
application, such as laudanum, &c.
[67] The fermenting poultice is made by adding a spoonful of yest to
an oatmeal poultice, and placing it before the fire until it begins to
emit air, or rise up in a bubbling way. It is then fit for applying to
the sore.
The same observations apply to the use of the gastric juice. Cloths
dipped in this sometimes make the overacting surface slough off,
and leave the parts below more healthy. The same may be said of the
expressed juice of sorrel.
Lime water sometimes operates in the same way.
Red precipitate, mixed with its weight of powdered opium, and half its
weight of camphor, may be usefully sprinkled over the surface.
A pound of the recent leaves of hemlock, boiled for half an hour in
two pounds of milk, and then expressed, forms an application which
sometimes abates the pain, and renders the action more healthy. The
juice is to be made into a poultice with crumb of bread.
Decoction of the walnut tree leaves, applied by means of pledgets of
linen, or made into a poultice with bran, is occasionally of service.
When, by any of these applications, the morbid state of the ulcer is
removed, it is to be dressed according to the genus into which it is
then converted.
After these remarks, the treatment of this genus of ulcers may be
comprised in the following observations:
First, In the first variety of the first species, or the simple
fungous ulcer, the cure is to be attempted by pressure, and gentle
stimulants, which render the action more natural, and the granulations,
in consequence, more perfect and compact.
Second, In the second variety of this species, we are to employ the
same remedies, as palliatives, or as means which may promote the
exfoliation of the bone. But, if the disease in the bone be more
extensive and tedious, we must cut down through the ulcer, and apply
caustic, or mechanical cures, such as perforation, to the caries.
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