16 On the Treatment of Burns and Scalds. 
I have not unfrequently traced the mild or superficial species 
of paronychia (whitlow) to the frequent application of cold, 
the end of the finger or thumb having been previously accidentally 
pricked, or slightly injured by some means or other, and neg~ 
lected. 
» With respect, to my opinion of the nature of the injury re- 
eeived in durns and scalas, atid rationale of the mode of treat- 
met to be adopted in such cases, it is briefiy this—that the 
effect continues to go on, in a certain degree, although the direct 
application of the cause has ceased to act; as is apparent, I 
think, by the painfully burning heat which remains. 
Hence the immediate mode of treatment is evidently pomted 
out to consist. in the application of cold, and which I have no 
doubt, if effectively used, would completely arrest or prevent the 
progress of such effect, leaving the parts, as far as the cold could 
immediately penetrate, precisely in the same state as at the in- 
stant of commencing the pr Qcess. 
The same mode of reasoning will apply equally to the injury 
produced by an inverse effect to the former, viz. the direct appli- 
cation of extreme cold to the surface of the body or limbs, and 
which, from its similarity in effect to burns and scalds, has not 
been unaptly termed cold-burning* ; the effects in one instance 
being produced by the sudden introduction of heat or caloric, 
and the other by the sudden abstraction of it, by means of the 
most powerful conductors of heat, allowing for the difference 
between the posifive and negative mode of action in the two 
instances. 
. For obvious reasons, I think, the best mode of applying cold 
or heat, in such cases, is by the medium of a liquid, and com- 
municated by immersion, in all instances which admit of it; 
and although I have mentioned the degree of 50° of Fahrenheit 
as the fittest temperature, it will be necessary to attend to the 
feelings of the patient, and regulate the degree of cold applied, 
throughout the process, to that temperature which affords most 
ease. 
In the course of my professional experience both in physic and 
in surgery, Lhave rarely found plain reason and fact at variance 
with each other; and I think we shall not err in admitting, in 
the present instance, that cold is the genuine and proper antidete 
for the effects of heat; and vice versd. 
It will however be obvious, that the application of the re- 
medy, in all instances, should be proportionate to the manner 
in which the injury is received, or comniunicated: thus, if it be 
* Mereury frozen, or any polished metal at the same temperature, will 
quickly destrey the living principle of the skin, and produce vesication. 
direct 
