Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Ointments.+ In the list of ointments, the much vaunted virtues of
advertised compounds are usually found.
Ointments and oils are used in the treatment of wounds and ulcers,
either to stimulate granulations or to soften thick epidermis.
Ointments should never be used where there is a profuse discharge, as
eczema is a complication which very often follows such treatment.
A great many different kinds of ointments are used and among these
are:
_Sulphur_ in 10 per cent. strength, or _ammoniated mercury_ up
to 5 per cent., where a paraciticide is indicated.
_Balsam of Peru_ in 10 per cent. strength for the stimulation
of granulations; or _balsam of Peru_ and _castor oil_, equal
parts; also _boric acid_, or _ichthyol_ for their antiseptic
properties.
Ten per cent. _mercurial_, for syphilitic cases.
_Lassar’s paste_ (which consists of salicylic acid, one dram,
starch and zinc oxide, each one ounce, and vaselin to make 4
ounces) is used when there is an eczema present.
One of the oldest as well as one of the best applications is balsam of
Peru, which has a powerful effect in increasing the growth of
granulations, but often after this has occurred the granulations are
apt to become exuberant with little tendency to cicatrization.
The ointment which has given the best results is _scarlet red_, an
aniline dye, which is known chemically as a sodium salt of a
disulphonic acid derivative. Scarlet red (Biebrich) was originally
prepared as a dye for wool and silk, and is so named because of the
fact that it was first manufactured in the town of Biebrich. It was
first used for medicinal purposes in 1907 in an 8 per cent. strength;
because this strength was found to be too irritating, it was
alternated with a bland ointment every 24 hours. It is now used only
in strengths varying from one-half to five per cent., for the latter
has proved to be as strong as necessary. When applied to granulating
surfaces, scarlet red is sometimes absorbed in sufficient amount to
color the urine a bright red, and a number of acute cases of nephritis
have been reported from its use.
Its application to granulating surfaces causes healing, not by the
formation of scar tissue, but in every case by producing a high grade
of normal skin (this can be demonstrated by sections), which very soon
becomes freely movable on the underlying tissue. The return of
sensation in the healed area takes place from the periphery inward,
instead of upward from the underlying tissue.
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