Healthy ulcers, if very extensive, produce likewise considerable
effects on the constitution. This is chiefly perhaps owing to the
purulent action, which makes a part of the ulcerative one; for this
morbid local secretory action induces a general change, in the same
way as other acute changes, of either the formative action itself,
or any other intimately connected with it, such as the interstitial.
But, besides this cause, the granulating action, although healthy,
co-operates with the diseased interstitial action, or the purulent
part of the ulcerative action; because, although the granulations, or
organic particles, be healthy, yet they are formed in an unnatural
situation, and with greater rapidity, and in greater numbers, in a
given time, than naturally they ought to be; and, therefore, the
action of the part requires greater power for its continuance than is
possessed. There is consequently, then, weakness produced, which, by
association, affects the system, and co-operates with the diseased
formative action, increasing the general disease. The consequence of
this state, likewise, is, that the ulcer comes, after some time, to
be rendered unhealthy, owing to the deficiency of power to support
the necessary action; in which case, the granulating action comes to
be also diseased, and co-operates still more with the former morbid
condition of the interstitial vessels, or the purulent action, which,
although a part of a healthy ulcerative action, is yet itself a morbid
secretion, and an unnatural action.
The effects of the ulcerative action on the constitution, are to be
alleviated by good diet, free air, and the other remedies which have
been pointed out when formerly considering hectic, to which I now
refer. I shall only observe, that some of these remedies are employed
occasionally with little judgment, and when they are not indicated. It
is, for instance, a common practice with some, to prescribe the bark
for the cure of every ulcer, whether the constitution be affected or
not. But, from many trials, I am confident that it is of very little
service, unless when a general disease, whether it be called weakness
or hectic, exists.
When the proper remedies for the cure of hectic, conjoined with
necessary local applications, fail, the diseased part must be removed;
but, before doing so, it is, in every instance, proper to form a pea
issue, in order still to keep up a secretory action, the good effects
of which have been already noticed.
The restlessness, and febrile symptoms, which are sometimes produced by
painful sores, are best relieved by anodynes.
_Of the Cure of the Inflammatio Debilis, and the Treatment of
Mortification._
Public-domain text, read in full here on John Shaqi.
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