On the Treatment of Burns and Scalds. 15 
presses, frequently renewed, and the administration of cooling 
liquors. 
To these observations, already too long perhaps, I shall sub- 
join a circumstance or fact, which perhaps is not irrelevant to 
the present subject ; and which by a kind of inverse analogy may 
tend to confirm, if further confirmation were wanting, the pro- 
priety of the mode of treatment I have recommended in burns 
and scalds. By the topical application of extreme cold to 
the skin, as in handling polished metal at a very low tempera- 
ture, the same effects are produced as in the instance of a burn 
produced by heated iron, &c. viz. vesication, &c. In like man- 
ner, as the application of cold in burns or scalds is a specific 
remedy ; so likewise is the application of heat in this instance— 
each used discretionally ; viz. by immersion of the part in a 
liquid of opposite temperature, duly adjusted. Moreover, in- 
stances of the same kind, in a smaller degree, are very familiar 
to me, in extreme cold weather, viz. in myself, as well as others. 
By frequent immersion or washing the hands, at such a season, 
in cold water, and exposure to the cold air, the tips of one or 
_ more of the fingers (these parts from the thinness of the skin 
there being most susceptible of such an effect, and even without 
any abrasion of the skin,) become tender, proceeding onto vesica- 
dion and ulceration, if this mode be persisted in; whereas, by 
avoiding the cause, and using warm water, and defending them 
from the effect of the cold air by wearing a glove, the progress 
of the injury is checked at the commencement; or, by appropriate 
dressings or cataplasms, together with immersion in warm water, 
and protection from cold, which is indispensable, are, in an ad- 
vanced state, cured. I have several times, for want of attention 
in time, experienced myself the effects of this kind of injury, as 
far as to the vesication and separation of the cuticle; and in 
other persons, on to a state of udceration. Even in an incipient 
state of this affection, the application of cold water, or exposure 
to cold air, is extremely painful, and in an advanced state, in- 
tolerably so; whereas, on the other hand, immersion in warm 
water immediately restores, or produces perfect ease. . The af- 
fection | am speaking of is not to be confounded with that of 
chilblain, from which it differs materially ; the ‘effect arising 
from the sudden communication of intense cold to the skin, or 
surface of any part, by a quick or powerful conductor of heat, as 
polished metal, or the frequent repetitions of it, in a slighter 
degree ; thus producing effects similar, by an inverse cause, to 
handling hot iron, or subjecting the hands repeatedly to very hot 
water*, 
' #* Te will be readily understood, that in this instance the conductor ope- 
rates by taking away the heat from the part. 
: I have 
