The remedies for this disease are such as tend to induce an action
similar to the natural one, by which we remove the diseased one; for
we know of none which excite the natural action directly, otherwise
they would be of universal utility, and would, in the present instance,
be preferred to every other. The remedies which we employ with this
intention, are bark, opium, &c. internally, and vinous, or spiritous
applications externally. These, however, would be pernicious, were
there no inflammation present, because they would, by exciting action,
tend to induce this; but, when, the inflammatory action is once
induced, then, as they excite one more nearly resembling the natural
one, they are useful; for, on the one hand, they destroy the morbid
one, and, on the other, increase the power of recovery; but, for this
purpose, internal medicines, and good diet, must be given, as a source
whence the energy is to be renewed, by the renewal of the natural
action. Heat is of the most pernicious tendency in this complaint;
because it simply increases the exciting action, and, therefore,
makes the inflammatory action still more violent. The applications,
therefore, ought to be cold, as long as the morbid action continues;
but, when it is abating, and recovery is going forward, they may be
made a little warmer, as they will thus accelerate the healing process
which is taking place; but this requires much prudence.
Spirit of wine is one of the best applications in this disease, and is
one very generally employed. Camphor is frequently added to it, and
appears to increase its efficacy. Pledgets dipped in camphorated spirit
of wine, and applied to the part, will, if frequently renewed, in many
cases, remove the inflammation, and prevent gangrene; but, in every
instance, it at least relieves the pain, which uniformly returns, if,
when the inflammation is violent, we omit the application, or use a
weaker spirit, such as the proof spirit.
Essential oils, particularly that of turpentine, which is easiest
procured, are also useful, but are inferior to the alcohol.
Laudanum, in slight cases, is useful as a topical application; but,
if the inflammation be more severe, it must be mixed with rectified
spirit. A very useful application may be prepared by adding two ounces
of laudanum to a pound of the spt. vin. camph. of the pharmacopœia.
Internally, the bark must be exhibited in full doses, with such a
quantity of wine as the feebleness of the pulse points out; but we
must be prudent in this respect, because, if we give too much, we may
increase the local disease. As long as it does not increase the pain,
or quicken the pulse, it is to be considered as useful.
Opiates are extremely necessary in the inflammatio debilis, and, in
general, require to be given freely.
Soups, and other articles of nourishing diet, are absolutely requisite,
and ought to be given in small quantities at a time, but frequently
repeated.
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