By these means, we may frequently resolve the inflammation completely;
but, at other times, when we have gained a certain ground, the
inflammation terminates in the suppurative action; or, in other words,
when the parts have gained more strength, and the action has come more
nearly to resemble the inflammatio valida, which has continued for some
time, a similar termination takes place. This event cannot, perhaps,
in these cases, be prevented, and, although it may occasionally
protract the cure, yet it diminishes the danger, making mortification
less to be dreaded. The best treatment, in these cases, perhaps, is
to continue our usual applications, avoiding warm poultices until the
action be fully formed; then moderate heat may accelerate the progress
of the abscess toward the surface. The same internal medicines must be
exhibited, the anodynes, however, being gradually diminished as the
pain (which marks the necessity for their use) abates.
It too frequently, however, happens, that either our remedies fail,
or the proper ones are not assiduously and judiciously employed, in
which case mortification takes place. This requires the same treatment,
in whatever way it is induced, only its progress is, from certain
causes, more rapid[70] in one case than in another, and, therefore,
requires the more free use of the appropriate remedies; but the
general principle is, in every case, the same, and, therefore, I shall
here consider the disease indiscriminately, whether it succeeds the
inflammatio valida, or debilis; because, in both instances, the case
is exactly the same, only, in the first, the weakness which induces
mortification, is produced by the inflammation alone, whereas, in
the second, it existed to a great degree before the inflammation was
excited.
[70] It is more rapid in the inflammatio debilis than in the
inflammatio valida, and in very delicate parts than in parts which are
less so.
Mortification is to be prevented from succeeding the inflammatio
valida, by timely bleeding, and the use of the agentes dissimiles, by
which we procure resolution, or at least make the induction of the
purulent action more easy. In the inflammatio debilis, it is to be
prevented by remedies of an opposite nature.
When, however, these remedies fail, and mortification does take place,
our great object must be to prevent it from extending far, and from
injuring the system. These intentions are answered by the same remedies
which cure the inflammatio debilis; because the local treatment of
mortification is merely that of the inflammatio debilis; for it is
only the parts which are still alive, or inflamed, which can be acted
on by our remedies.
The remedies are either general or topical, and may be considered under
these divisions; but both must be used at the same time.
Public-domain text, read in full here on John Shaqi.
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