238 DR. CHASE'S RECIPES. 



are covered with a thin film, which afterwards becomes opaque, and forms 

 skin. The principal thing to be done in the treatment of this kind of ulcer, 

 is to keep the surface clean by putting on a little dry lint, and a pledget over 

 It, covered with very simple ointment. In some patients ointment irritates and 

 inflames the neighboring skin. Bandages sometimes irritate the sore, and dis- 

 turb the healing process; but when they do not, they are useful in giving a 

 moderate support to the parts, and in defending those that are newly formed. 



3. Ulcers in Weakened Parts.— Other ulcers are in parts which 

 are too weak to carry on the actions necessary to their recovery. In them the 

 granulations are larger, more round, and less compact than those formed on 

 ulcers in healthy parts. When they have come up to the level of the healthy 

 parts, they do not readily form skin, but rising still higher, lose altogether the 

 power of forming it. When the parts are still weaker, the granulations some- 

 times fill up the hollow of the ulcer, and then are suddenly absorbed, leaving 

 the sore as deep as ever. Ulcers are very much under the influence of what- 

 ever affects the constitution; so that change of weather, emotions of the mind, 

 diet, and other agents, quickly occasion a change in their condition. Such 

 ulcers as we have been describing, require general as well as local treatment; 

 bark, wine, porter, and other cordials and tonics are to be given; and the gran- 

 ulations are to be kept from rising too much, by the prudent application of 

 blue vitriol, lunar caustic, and the like, weakened sufiiciently by proper admix- 

 ture of ointment to act as stimulants, and not as caustics. This will give a 

 proper and healthy action to the granulating surface; whereas the destroying 

 of the rising parts by escharotics seems rather to encourage the growth. 

 Bandages and -proper support to the parts are highly useful. These ulcers, in 

 weak parts, do not seem to be the better of poultices, or other relaxing applica- 

 tions; powders rarely do good, and perhaps the best dressing is the citrine oint- 

 ment, more or less diluted. 



4. Irritable Ulcers. — There are certain ulcers, which may be called 

 Irritable Ulcers. The margin of the surrounding skin is jagged, and termi- 

 nating in an edge which is sharp and undermined. There is no distinct appear- 

 ance of granulations, but a whitish spongy substance, covered with a thin 

 ichorous discharge. Every thing that touches the surface gives pain, and 

 commonly makes the ulcer bleed. The pain sometimes comes on in paroxysms, 

 and causes convulsive motions of the limb. Such ulcers seldom do well 

 without a frequent change of treatment. Fomentations with poppy heads, 

 chamomile flowers, or hemlock leaves, are sometimes of use in irritable ulcers, 

 'vv^hen poultices are prescribed, they should never be allowed to rest or bear 

 weight on the sore limb. Powdered applications are generally too stimulating 

 for irritable ulcers, and bandages also prove hurtful. 



5. Indolent Ulcers. — These ulcers are those which have the edges of 

 the surrounding skin thick, prominent, smooth, and rounded. The surface of 

 the granulations is smooth and glossy ; the matter is thin and watery, and the 

 bottom of the ulcer is nearly level. A great proportion of the ulcers in hos- 

 pitals are of the most indolent kind. Indolent ulcers form granulations, but 



