to repeat the application of the caustic to another part; or, when the
issue begins to dry up, to apply for a few hours a pledget of strong
antimonial ointment.
The employment of the bichloride of mercury, though a most efficient
escharotic, appears not to be unattended with danger, as in many
instances violent purging, with tenesmus and bloody stools, follow its
application. When swelling exists without pain, considerable advantage
may be derived from frictions and liniments of various kinds, with
careful bandaging. No applications can be of the least avail unless the
joint be kept completely at rest.
When there is no pain in the joint, when swelling exists, with or
without fluctuation, and there is every reason to believe that the
extremities of the bones are not much diseased, a cure may be, in
general, obtained by the employment of rest, support, and slight
superficial excitement. A practice which has been extensively and
rather indiscriminately pursued in diseases of joints and of other
parts, in affections of synovial membrane, ulceration of cartilage,
disease of bone, and even in cases of necrosis, is here detailed. It
is useful in proper cases, very hurtful in others. The joint is well
washed with soap and water, and afterwards rubbed with camphorated
spirits of wine: it is then covered with an ointment spread on lint,
and composed of equal parts of the unguentum hydrargyri cum camphora
and the ceratum saponis—in the majority of cases the mercurial ointment
would be better omitted—strips of lead, soap, or adhesive plaster are
then applied with a moderate degree of tightness round, from two or
three inches below the joint to the same distance above it: these are
covered with soap-plaster spread on thick leather, and the whole is
surrounded with a bandage, which extends from the extremity of the
limb. The bandage should be put on as far as the joint, before the
plasters are applied. The irritation produced on the surface tends
to check the deep-seated action, whilst the compression excites the
action of the absorbents to remove the effused fluids, and thus to
reduce the swelling: by the joint being kept completely motionless,
not the least salutary indication of the treatment, the cartilage and
bones, if ulcerated, are placed in a condition tending much to expedite
their restoration to a natural state. If they are diseased to such an
extent that the process of cicatrisation cannot be expected, a cure by
anchylosis is, by these means, much more likely to occur. The dressings
may be left undisturbed for the space of a week or two; at which
period, and, in many cases, sooner, they will be found much slackened,
in consequence of the swelling being greatly reduced. By repetition
of the application at intervals, the disease will, in a great many
instances, rapidly cease, and the joint resume almost its natural
appearance; but the period at which this takes place will be found
to vary much according to circumstances. If, however, the plasters
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