As the incipient stage of the first variety frequently consists of only one short paroxysm, it would often be unnecessary to have recourse to any peculiar treatment; but, as it is impossible, a priori, to say whether the state of evacuation is to continue, it is requisite, in every instance, to vary our treatment, and apply the proper remedies for the disease.
Poultices are frequently useful in this kind of ulcer, when the surface is dark coloured, and the integuments are not yet affected. They have sometimes an effect of checking the morbid state, if this be not already done; but they more generally promote the absorption of the morbid granulations, after which the surface becomes healthy. If, however, the action be still greater, and more permanent, then the ulcer is tending toward the confirmed, or perfect state of overaction, and poultices are not of equal service; they are even sometimes hurtful.
Gentle pressure, accompanied with the use of cold water, is of service in the same cases in which poultices are employed; that is to say, when the action has not become perfect, but has rather begun to subside, and the granulations remain dark coloured, and in a dying state. They are absorbed, and replaced with more perfect and healthy granulations.
When, however, the action still continues in the same state of overacting, or seems to be increasing, these remedies are rather hurtful; and we will derive more benefit from using applications of a gentle stimulating nature, which restore the action to a more perfect and natural state, in the same way as they cure the inflammatio debilis. For this purpose, one of the best applications is the following:
R. Opii drachmas duas.
Camphoræ scrupulum.
Vini Albi uncias quatuor. Macera per triduum, dein cola.
This may be applied by means or a bit of lint to the sore. It generally produces considerable smarting for a few minute, after which the pain abates. The application is to be repeated every hour, or every two hours, until the sore begins to look healthy, and the pain abates. The adhesive plaster ought then to be substituted in its place.
Laudanum may also be employed with the same intention, but it is inferior to the other.
Lemon juice is also sometimes useful, and may be employed where the opiated wine fails, or is not at hand.
When the state of overaction becomes confirmed, and progressive, the sore spreads, becomes very painful, and assumes the appearances which have been already described. In this case, the application of carrot, or turnip poultices, is frequently useful. These vegetables are sometimes made into a poultice by boiling them, and, at other times, by rasping them down raw.