In phagedena the patient ought to be, if possible, placed in an airy
and healthful situation. In most cases free bloodletting may be
necessary at the commencement, and will be advantageously followed
by purgatives and antimonials. The patient ought to be strictly
confined to his room, and ordered low diet with diluents. Afterwards,
the internal use of nitric acid, the decoction of sarsaparilla, and
an occasional dose of Dover’s powder at night, will be beneficial,
particularly if sleep be disturbed with pain of the bones and joints.
Mercury, even in small quantities, protracts the disease, and in
large doses it hastens the ulceration and sloughing. When all febrile
symptoms have subsided, when the ulcers are nearly healed, when no
fresh pustules appear, and when desquamation is begun, alterative
doses of mercury, as a blue pill or grey powder every second night,
may sometimes be ventured upon, will tend to hasten the cure, and will
not, possibly, be followed by any unpleasant symptoms. The safe course
is to promote the secretions by some safe substitute—preparations of
sarsaparilla, ipecacuan, taraxacum, &c.
In fact, in all scaly eruptions, whether scaly from their commencement,
or having become so in their latter stages and previously to their
disappearance, mercury, prudently administered, will be useful by
expediting the cure, and not injurious by deranging the system. The
tar or citrine ointments may be applied to the eruptions and cutaneous
ulcers.
For the ulcers of the throat, unless in a sloughing state, the lunar
stone appears to be almost a specific, removing the irritability of
the sores, and protecting them from further irritation by coagulating
the discharge, which then more effectually covers and protects them.
The application requires to be repeated every second or third day, as,
by the frequent and necessary motions of the parts, the crust loosens
and separates, leaving the surface exposed and irritable. At the same
time the sore will contract very considerably under each successive
crust. The lunar stone may also be applied in solution; or a solution
of the bichloride of mercury in spirits or laudanum may be used, in
the proportion of from four to six grains to the ounce, or stronger.
The solution of the nitrate of mercury is sometimes employed with
advantage. Fumigation of the throat with the red sulphuret of mercury
has been extolled as a powerful means of checking the alternating
sloughing and ulceration which often accompany the ulcers of these
parts, but the propriety of its employment is doubtful; the system
is thereby rapidly put under the influence of the mineral, which, as
already remarked, generally aggravates the violent disturbance under
which the constitution labours. More permanent good may be expected
from means taken to remedy the constitutional evils than from such
violent remedies as are directed against the affected part, but which
also produce a baneful effect on the system. In ulcers of the nostrils,
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