It sometimes happens, that the ulcerative action becomes converted
into the inflammatory; the discharge diminishes, and sometimes ceases;
the surface is red; and the edges and surrounding skin are elevated
and inflamed. This, which has been called the phlogosis ulceris[68],
strictly speaking, does not belong to the division of ulcers, because
the ulcerative action is destroyed; but, as it is preceded, and very
quickly followed by this action, and as the solution of continuity, and
other external appearances continue, this affection may be allowed to
rank as a genus amongst ulcers, in conformity to common language.
[68] “Siccitas rubido et phlogosis ulceris facile cognoscuntur; dolore,
pruritu, calore stipantur; ca impediunt carnis excrescentiam, adeoque
indicant remedia emollientia,” &c. Sauvage Nosol. Meth. Tom. II. p. 613.
When the pain and inflammation are considerable, leeches are frequently
applied with utility in the vicinity of the sore; but it is more
generally useful to apply warm poultices, which restore the secretory
state, and the ulcerative action.
GENUS V.
_Of the Suppurating Ulcer._
This genus, like the last, accurately speaking, does not belong to the
class of ulcers; but, as it is so intimately connected with it, both
in its causes, and treatment, and appearances, it is of some practical
utility to admit the arrangement.
When an abscess is opened before the ulcerative action is induced, we
have an open suppurating sore; but this is not the sore which is meant
to be described here.
The suppurating ulcer is, when simple, and independent of any specific
action, most frequently only a high degree of the overacting ulcer;
but, as its symptoms are somewhat different, and as it nearly resembles
some specific sores, differing from these only in the absence of the
peculiar action, resulting from the application of a poison, it may be
proper to consider this as a separate genus.
When the ulcerative action is very imperfectly carried on, which often
arises from overaction, we find, that the organic particles are thrown
out, not in the form of granulations, but in a more inorganic state,
and lie upon the surface, mixed with the discharge from the other set
of vessels. This has the appearance of very thick tough pus, and the
sore which yields it may properly be considered to be in a suppurating
state. This ulcer is distinguished by the pain which attends it, by a
redness which surrounds the margin, and a hardened base, whilst the
cavity of the ulcer is filled up with a thick straw-coloured substance,
somewhat like lymph, which adheres firmly to the surface. This is
improperly called a slough.
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