In trifling burns cold applications are generally used—as immersing the
part in cold or iced water. A great variety of remedies are employed,
spiritous, watery, acid, alkaline, cold or hot; some apply a coat of
cotton or flour, some of tar or pitch, and they state that when these
artificial crusts separate, the skin is found healed beneath; in fact,
every practitioner, and almost every individual, possesses a favourite
application for this very common accident. Some have recommended
holding the part to the fire, or plunging it into hot liquid; but this
practice, and all similar, are too severe ever to become general,
when milder means prove equally effectual. Perhaps the most common
applications are, a mixture of lime-water and olive oil, or the ceratum
acetatis plumbi. The vesicles, when left to themselves, burst, expose
an irritable surface, and the acrid discharge from them excoriates
the surrounding skin. Their contents ought to be evacuated by a small
puncture, and the cuticle being left carefully undisturbed, a scab
soon forms, by which the part is protected while healing. In extensive
injuries of the skin, where the cuticle has been altogether destroyed,
finely carded cotton is sometimes applied; it is of use in somewhat
the same way as the cuticle in the former instance, and being a sort
of cushion over the part, prevents it from being irritated by bed or
body clothes, or by the patient’s resting on it. It soon becomes soaked
with the discharge, and must either be frequently changed, or become a
receptacle for pus to putrefy in, and maggots to breed; on account of
these circumstances it is objectionable. Dusting the part with common
flour, starch, or hair powder, is equally advantageous, and much more
convenient; relief is afforded by its immediate application; the parts
are cooled; the flour, absorbing the discharge, is soon formed into
crusts, which effectually protect the surface; and the after-secretion
readily escapes from beneath this, no more moisture being imbibed than
is merely sufficient for the encrustation. The artificial covering
ought not to be removed until completely detached, by purulent matter
accumulating beneath it; then its presence can be of no service, and
its removal is accomplished by fomentation or poultice, and without
pain to the patient; whereas, by pulling off the crusts shortly after
their formation, as some do, whilst they are adherent to the surface,
and protecting it from injury, much pain is given to the patient, the
raw surface is irritated, and made liable to over-action; a useful
application is taken away to make room for another, and, perhaps, not
so congenial. After the spontaneous separation, fresh flour may be
again sprinkled over the suppurating surface, and, if the affected part
is small, it may heal under this application. But when, in burns of
considerable extent, suppuration is fully established, and granulations
have begun to arise, tepid-water dressing, and lotions, are to be
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