The causes and nature of mortification having been already explained,
I shall now consider the means of prevention, and the method of cure.
The remedies necessary for procuring the resolution, or suppuration of
the inflammatio valida, having been formerly enumerated, it will be
unnecessary here to make any repetition, or to say more than that we
are to prevent mortification by endeavouring to induce one or other of
the other terminations, and that the remedies which do so are to be
employed with a promptitude and assiduity proportioned to the greatness
of the action compared to the powers of the part; and, therefore, that
in the intestines, &c. we must pursue our course speedily, if we
expect to prevent gangrene.
Mortification, however, is still more apt to succeed the inflammatio
debilis, or inflammation of weakened parts; and, therefore, the
treatment of this will now more naturally come to be considered, as
forming a part of the prophylaxis of mortification, than in any other
place.
The most frequent instance which we have of the inflammatio debilis,
is the inflammation of parts which have been previously benumbed with
cold; but it may also be produced by the action of any of the common
exciting causes of inflammation, in weak and reduced habits, or by
bruises in sound parts, &c.
When a part has been exposed to much cold, it may inflame, from two
causes: First, the communication of action; secondly, the application
of subsequent stimulants, more especially heat. Both of these tend to
excite an action in the part, which is greater than its power would
naturally perform, and, therefore, it becomes diseased, or inflammation
is produced, and the little energy which did remain is soon destroyed.
The operation of the first cause is prevented by lessening the action
of the surrounding parts, by the application of moderate cold, whilst
we avoid motion, and whatever may tend to act directly on the part,
and co-operate with this cause. The operation of the second cause is
prevented by keeping away every agent which will tend to excite action,
or at least those which tend to do so suddenly. In the generality of
cases, it is perhaps most proper at first to do nothing; because,
whatever we apply, tends to excite a greater action than can be
sustained; we ought, therefore, to delay any remedy until the part
has begun to recover itself, and the action and corresponding power
has begun naturally to increase; we may then interfere, by applying
such remedies as increase the action, which are perhaps now more
useful, by preserving the ground which is gained, than by increasing
still farther the action. Of this kind is heat, which must, upon this
principle, be applied with great caution, and must, in its degree, be
nicely adjusted to the existing state of action. When a part, then, is
benumbed with cold, we ought at first to apply a degree of heat, very
little above that which the parts were formerly exposed to, which, in
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