When a wound is greatly inflamed, the most proper application is a poultice of bread and milk, softened with a little sweet oil or fresh butter. This must be applied instead of a plaster, and should be changed twice a-day.
If the wound be large, and there is reason to fear an inflammation, the patient should be kept on a very low diet. He must abstain from flesh, strong liquors, and every thing that is of a heating nature. If he be of a full habit, and has lost but little blood from the wound, he must be bled; and, if the symptoms be urgent, the operation may be repeated. But when the patient has been greatly weakened by loss of blood from the wound, it will be dangerous to bleed him, even though a fever should ensue. Nature should never be too far exhausted. It is always more safe to allow her to struggle with the disease in her own way, than to sink the patient’s strength by excessive evacuations.
Wounded persons ought to be kept perfectly quiet and easy. Every thing that ruffles the mind or moves the passions, as love, anger, fear, excessive joy, &c. are very hurtful. They ought above all things to abstain from venery. The body should be kept gently open, either by laxative clysters, or by a cool vegetable diet, as roasted apples, stewed prunes, boiled spinage, and such like.
OF BURNS.
In slight burns which do not break the skin, it is customary to hold the part near the fire for a competent time, to rub it with salt, or to lay a compress upon it dipped in spirits of wine or brandy. But when the burn has penetrated so deep as to blister or break the skin, it must be dressed with some of the liniment for burns mentioned in the Appendix, or with the emollient and gently drying ointment, commonly called Turner’s cerate[[197]]. This may be mixed with an equal quantity of fresh olive oil, and spread upon a soft rag, and applied to the part affected. When this ointment cannot be had, an egg may be beat up with about an equal quantity of the sweetest salad-oil. This will serve very well till a proper ointment can be prepared. When the burning is very deep, after the first two or three days, it should be dressed with equal parts of yellow basilicum and Turner’s cerate mixed together.
When the burn is violent, or has occasioned a high degree of inflammation, and there is reason to fear a gangrene or mortification, the same means must be used to prevent it as are recommended in other violent inflammations. The patient, in this case, must live low, and drink freely of weak diluting liquors. He must likewise be bled, and have his body kept open. But if the burnt parts should become livid or black, with other symptoms of mortification, it will be necessary to bathe them frequently with warm camphorated spirits of wine, tincture of myrrh, or other antiseptics, mixed with a decoction of the bark. In this case the bark must likewise be taken internally, and the patient’s diet must be more generous.
As example teaches better than precept, I shall relate the treatment of the most dreadful case of this kind that has occurred in my practice. A middle-aged man, of a good constitution, fell into a large vessel full of boiling water, and miserably scalded about one half of his body. As his clothes were on, the burning in some parts was very deep before they could be got off. For the first two days the scalded parts had been frequently anointed with a mixture of lime-water and oil, which is a very proper application for recent burnings. On the third day, when I first saw him, his fever was high, and his body costive, for which he was bled, and had an emollient clyster administered. Poultices of bread and milk, softened with fresh butter, were likewise applied to the affected parts, to abate the heat and inflammation. His fever still continuing high, he was bled a second time, was kept strictly on the cooling regimen, took the saline mixture with small doses of nitre, and had an emollient clyster administered once a-day. When the inflammation began to abate, the parts were dressed with a digestive composed of brown cerate and yellow basilicum. Where any black spots appeared, they were slightly scarified, and touched with the tincture of myrrh; and, to prevent their spreading, the Peruvian bark was administered. By this course, the man was so well in three weeks as to be able to attend his business.
OF BRUISES.
Bruises are generally productive of worse consequences than wounds. The danger from them does not appear immediately, by which means it often happens that they are neglected. It is needless to give any definition of a disease so universally known; we shall therefore proceed to point out the method of treating it.
In slight bruises it will be sufficient to bathe the part with warm vinegar, to which a little brandy or rum may occasionally be added, and to keep cloths wet with this mixture constantly applied to it. This is more proper than rubbing it with brandy, spirits of wine, or other ardent spirits, which are commonly used in such cases.