[64] No external application whatever will produce the same good effect, if used by itself, as when such a general action is induced as shall co-operate with the local remedies. In slight cases, thirty drops of laudanum may be given twice a-day; but, when the overaction is more violent, the dose must be more frequently repeated.
[65] This was probably recommended on account of the sphacelated appearance which these sores sometimes have.
[66] Let two ounces of camomile flowers be boiled in three pounds of water down to two. When this is cold, it ought to be strained, and half a drachm of opium diffused in a pound of the decoction. Of this, a sufficient quantity is to be added to powdered charcoal, in order to form a poultice.
[67] The fermenting poultice is made by adding a spoonful of yest to an oatmeal poultice, and placing it before the fire until it begins to emit air, or rise up in a bubbling way. It is then fit for applying to the sore.
[68] “Siccitas rubido et phlogosis ulceris facile cognoscuntur; dolore, pruritu, calore stipantur; ca impediunt carnis excrescentiam, adeoque indicant remedia emollientia,” &c. Sauvage Nosol. Meth. Tom. II. p. 613.
[69] See the preliminary dissertation.
[70] It is more rapid in the inflammatio debilis than in the inflammatio valida, and in very delicate parts than in parts which are less so.
[71] The necessity for this, and other remedies, is in general proportioned to the continuance of the disease, and the progress which it has made. In this, as in every other disease, we must be attentive to the effects of our remedies, and consider these in forming our opinion.
[72] The hot, and almost boiling oils, which were poured into these incisions, contributed not a little to increase the disease.
[73] As an illustration of this rule, I may mention the following case: A man, during a voyage to a cold climate, had both his feet frost-bit, in consequence of which mortification ensued. In this state he continued for two or three weeks, during which he received very little medical aid. When I saw him, both his feet were mortified, from the toes to about three inches above the ankle joints, his pulse was feeble, very frequent, and intermittent, the strength was greatly impaired, and the countenance sunk and ghastly. The ulcerative action had been induced for some time, but the want of wine and proper diet had prevented the system from gaining by the cessation of the local disease. He began the use of the bark, opium, wine, and soups, which he took very liberally, in consequence of which his pulse became slower, and his strength increased. In two days, one of the ankle joints was removed by clipping through the tendons, and, in a few days more, the other came away. Amputation was now performed below the knee of the right leg, the constitution, instead of gaining, rather beginning to lose ground. The subsequent affection of the system was by no means great, and, in about a week, he was much stronger; but, as the bones of the ankle joint of the other leg were carious, he again began to sink. Amputation was therefore performed on the left side, in about three weeks after the first. During the cure, the wine, opium, and nourishing diet, were freely prescribed.