The local treatment is to be conducted on the same principle as in
the cure of the inflammatio debilis. Pledgets, dipped in the oil of
turpentine, tincture of myrrh, or rather in camphorated spirit of wine,
which is one of the best applications which can be used, ought to be
made use of.
These remedies can do little service when applied to the dead portion;
but, as the whole part does not die at once, there are always some
portions which are still in the inflamed state, and on which they act.
They likewise prevent the progress of the disease, by operating on
the skin which is contiguous to the gangrene. Every mortification, in
general, attacks the skin first; or, in other words, the inflammatio
debilis spreads faster along the skin than along the deeper parts; but,
when once the skin is inflamed, and mortifies, the disease extends to
a greater or less depth below the surface. Whatever, then, operates on
the surface, and prevents the progress of the inflammation, or cures
the part which is already inflamed, will tend to check the extension
of the disease, especially if the proper internal remedies be made use
of with a view to prevent the extension of the action of descent.
Formerly, in order to allow these remedies to come in contact with
the living parts, it was customary to make incisions through the dead
portion, and not unfrequently through part of the living substance.
But, as these cannot prevent the extension of the disease over a
greater surface, and, as the irritation which is given, and the
exposure of parts which have not yet assumed the ulcerative action,
tend to increase the inflammatio debilis, the practice must be
considered as improper[72]. It is now indeed almost universally laid
aside, owing, in a great measure, to the observations of the ingenious
Mr. Pott.
[72] The hot, and almost boiling oils, which were poured into these
incisions, contributed not a little to increase the disease.
Antiseptics, such as decoction of camomile flowers, &c. have been
recommended as external applications; but, whatever effects they may
have on the matter which is already dead, it is evident that they can
be of no service in preserving the living parts from suffering death.
All that can be expected from them is to check the putrefaction of
the dead substance, which they have very little power to do; and,
therefore, they can never come into competition with more valuable
remedies, such as the camphorated spirit of wine, &c.
Public-domain text, read in full here on John Shaqi.
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