The wine is very usefully conjoined with the bark, and is even of
considerable use by itself, when the bark is rejected. Its operation is
more speedy than that of the bark, but it is perhaps more fugacious.
The quantity which is necessary to be given depends upon the effect of
the local disease upon the system, and on the inability to bear other
remedies. A table spoonful may be given in general every quarter of an
hour, unless it increase the pain, and frequency of pulse, and produce
restlessness, and heat of the skin. In these circumstances, we may be
certain that we have increased the quantity beyond the necessity[71].
[71] The necessity for this, and other remedies, is in general
proportioned to the continuance of the disease, and the progress which
it has made. In this, as in every other disease, we must be attentive
to the effects of our remedies, and consider these in forming our
opinion.
Opium is likewise an useful remedy in this disease, and ought never
to be omitted; because it not only diminishes the irritability, and,
consequently, the pain, but likewise, like the wine and the bark,
counteracts, by the induction of its peculiar action, the progress
of the inflammatio debilis, and, consequently, tends to check the
mortification. This medicine is most usefully exhibited in full doses,
which not only procure ease, but also frequently make the stomach more
readily bear other remedies. One grain of the extract, or twenty-five
drops of the tincture, may be given at once, and the dose repeated
whenever the action of the former subsides. After some time, each dose
must be increased one half, and presently doubled, in order to produce
the same effect as it did at first.
These remedies may give a temporary check to the disease; but, unless
nourishment be conjoined, in every possible form, they will not of
themselves be able to effect a cure, if the disease be tedious. Soups,
jellies, milk, sago, &c. must be assiduously given in small quantities,
and even thrown up as clysters, if the stomach cannot bear them.
Vegetable acids, fixed air, wort, &c. have been recommended in this
disease, probably upon the supposition of the existence of a putrescent
matter, or from their utility in scurvy. Wort, however, and fixed air,
do not appear to be of very great benefit in this disease, at least
they are by no means to be put in competition with other remedies of
more approved efficacy, or allowed to interfere with their exhibition.
The acid of lemons seems to be more generally useful than the carbonic
acid; and, perhaps, the nitrous acid would be equally useful with the
citric acid. These acids do not operate by counteracting putrefaction,
but by counteracting the action of descent, inducing a more healthy
action, and tending to excite ulceration, which is the mean employed
for separating the dead part, and producing restoration. For this
purpose, however, the acids must be given freely, otherwise no good is
done.
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