410 DISEASES OF THE HOESE. 



In Other cases it will be found that suppuration is well under way, 

 so that the center of the tumor is soft when the patient ic first pre- 

 sented for treatment. It is always good surgery to relieve the tumor 

 of pus whenever its presence can be detected ; hence, in these cases a 

 free incision must be made into the softened parts, tlie pus evacu- 

 ated, and the foot j^oulticed. 



By surgical interference the tumor is now converted into an open 

 sore or ulcer, which, after it has been well cleaned l)y warm baths 

 and poultices applied for two or three days, needs to l)e protected by 

 proper dressings. The Ijest of all protective dressings is made of 

 small balls, or pledgets, of oakum, carefully packed into the wound 

 and held in place by a roller bandage 4 yards long, from 3 to 4 inches 

 wide, made of common bedticking and skillfully applied. 



The remedies which may be used to stimulate the healing process 

 are many, and, as a rule, they are applied in the form of solutions or 

 tinctures. 



In mj own practice I prefer a solution of bichlorid of mercury 1 

 part, water 500 parts, with a few drops of muriatic acid or a few 

 grains of muriate of anunonia added to dissolve the mercury. The 

 balls of oakum are wet with this solution before they are applied to 

 the wound. 



Among the other remedies which may be used, and perhaps with 

 equally as good results, will be noted the sulphate of copper, iron, and 

 zinc, 5 grains of either to the ounce of water ; chlorid of zinc, 5 grains 

 to the ounce ; carbolic acid, 20 drops dissolved in an equal quantity of 

 glycerin and added to 1 ounce of water; and nitrate of silver. 10 

 grains to the ounce of water. 



If the wound is slow to heal, it will l)e found of advantage to 

 change the remedies every few days. 



If the wound is pale in color, the granulations transparent and 

 glistening, the tincture of aloes, tincture of gentian, oj- the spirits of 

 camphor may do best. 



Wlien the sore is red in color and healing rapidly, an ointment 

 made of 1 part of carbolic acid to 40 parts of cosmoline or vaseline is 

 fll that is needed. 



If the granulations continue to groAv until a tumor is formed which 

 ])i-ojects heyond the surrounding skin, it should be cut off with a 

 sharp, clean knife, and the foot poulticed for twenty-four houi-s, 

 after which the wound is to be well cauterized daily with lunar 

 caustic and the bandages applied with great firmness. 



Tlie question as to how often the dressings should be renewed must 

 be determined by the condition of the womid, etc. If the sore is sup- 

 purating freely, it will be necessary to renew the dressing every 

 24 or 48 hours; if the discharge is small in quantity and the patient 

 comfortable, the dressing may be left on for several days: in fact. 



