This genus, like the last, accurately speaking, does not belong to the class of ulcers; but, as it is so intimately connected with it, both in its causes, and treatment, and appearances, it is of some practical utility to admit the arrangement.
When an abscess is opened before the ulcerative action is induced, we have an open suppurating sore; but this is not the sore which is meant to be described here.
The suppurating ulcer is, when simple, and independent of any specific action, most frequently only a high degree of the overacting ulcer; but, as its symptoms are somewhat different, and as it nearly resembles some specific sores, differing from these only in the absence of the peculiar action, resulting from the application of a poison, it may be proper to consider this as a separate genus.
When the ulcerative action is very imperfectly carried on, which often arises from overaction, we find, that the organic particles are thrown out, not in the form of granulations, but in a more inorganic state, and lie upon the surface, mixed with the discharge from the other set of vessels. This has the appearance of very thick tough pus, and the sore which yields it may properly be considered to be in a suppurating state. This ulcer is distinguished by the pain which attends it, by a redness which surrounds the margin, and a hardened base, whilst the cavity of the ulcer is filled up with a thick straw-coloured substance, somewhat like lymph, which adheres firmly to the surface. This is improperly called a slough.
This appearance and condition may be excited in a simple ulcer, without any apparent application of contagion; but it is still more frequently the consequence of some morbid matter acting on the part, and producing specific ulceration, which will be afterwards considered. I may only here observe, that it has, in some of these cases, been considered as a species of gangrene, as, for instance, in the cynanche maligna; but, whatever may take place in the advanced stages of this disease, there is at first no gangrene, but a suppurating ulcer, which throws out imperfect granulations, or rather a morbid purulent discharge (for the one runs naturally into the other), which forms what is called a slough.
The treatment of this ulcer consists first in procuring a separation of the tenacious covering, by such remedies as shall, at the same time that they do this, make the action more healthy.
A pretty strong solution of the argentum nitratum, or l’eau mercurielle, diluted with equal parts of distilled water, applied by means of a brush, frequently produce the desired effect.
The acetous infusion of Cayenne pepper, applied in the same way, is likewise useful.