Cancers on the face are said to arise from the periosteum, and that unless this be destroyed by the knife, or by caustics, the cancer certainly recurs. After the cancer becomes an open ulcer of some extent, a purulent fever supervenes, as from other open ulcers, and gradually destroys the patient. See Class [II. 1. 6. 13].
Two very interesting cases have been lately published by Dr. Ewart, of Bath, in which carbonic acid gas, or fixed air, was kept constantly in contact with the open cancerous ulcers of the breast; which then healed like other common ulcers. This is rather to be ascribed to the exclusion of oxygen, than to any specific virtue in the carbonic acid. As in common ulcers the matter does not induce hectic fever, till it has been exposed to the air, and then probably united with oxygen.
The manner of applying the fixed air, is by including the cancer in one half or hemisphere of a large bladder; the edges are made to adhere to the skin by adhesive plaster, or perhaps a mixture of one part of honey with about twenty parts of carpenter's glue might better suit some tender skins. The bladder is then kept constantly filled with carbonic acid gas, by means of a pipe in the neck of it; and the matter let out at a small aperture beneath.
[17]. Arthrocele. Swelling of the joints seems to have its remote cause in the softness of the bones, for they could not swell unless they were previously softened, see Class [I. 2. 2. 14]. The epiphyses, or ends of the bones, being naturally of a looser texture, are most liable to this disease, and perhaps the cartilages and capsular ligaments may also become inflamed and swelled along with the heads of the bones. This malady is liable to distort the fingers and knees, and is usually called gout or rheumatism; the former of which is liable to disable the fingers by chalk-stones, and thence to have somewhat a similar appearance. But the arthrocele, or swelling of the joints, affects people who have not been intemperate in the use of fermented or spirituous liquors; or who have not previously had a regular gout in their feet; and in both these circumstances differs from the gout. Nor does it accord with the inflammatory rheumatism, as it is not attended with fever, and because the tumors of the joints never entirely subside. The pain or sensibility, which the bones acquire, when they are inflamed, may be owing to the new vessels, which shoot in them in their soft state, as well as to the distention of the old ones.
M. M. Half a grain of opium twice a day, gradually increased to a grain, but not further, for many months. Thirty grains of powder of bark twice a day for many months. Ten grains of bone-ashes, or calcined hartshorn, twice a day, with decoction of madder? Soda phosphorata?
[18]. Arthropuosis. Joint-evil. This differs from the former, as that never suppurates; these ulcers of the joints are generally esteemed to arise from scrophula; but as scrophula is a disease of the lymphatic or absorbent system, and this consists in the suppuration of the membranes, or glands, or cartilages about the joints, there does not seem a sufficient analogy to authorize their arrangement under the same name.
The white swelling of the knee, when it suppurates, comes under this species, with variety of other ulcers attended with carious bones.
[19]. Caries ossium. A caries of the bones may be termed a suppuration of them; it differs from the above, as it generally is occasioned by some external injury, as in decaying teeth; or by venereal virus, as in nodes on the tibia; or by other matter derived to the bone in malignant fevers; and is not confined to the ends of them.
The separation of the dead bone from the living is a work of some time. See Sect. XXXIII. 3. 1.