LOCAL INFLAMMATION. 435 



the connexion between the body and the substance to be 

 sloughed away is destroyed, through the interposition of a 

 liquid. This process is one of extreme suffering. It is 

 effected at a great expenditure of nervous energy ; but the 

 tranquillity which ensues is great, and enables the animal 

 to recover from the exhaustion. 



Gangrene. — When debility to a great degree takes place, 

 inflammation falls into gangrene. If the parts near to 

 the seat of inflammation likewise are weak, they usu- 

 ally become gangrenous also ; but if they are strong, the 

 edges assume a deep-red appearance, pus is secreted, and 

 by this means a separation of the dead from the living 

 takes place. It is, therefore, our duty to prevent this ex- 

 tension of gangrene to the sound part, and to promote the 

 removal of all dead portions from the living body. To 

 effect this, we must attend to the system generally ; for upon 

 a salutary effect on the constitution at large we are to 

 depend upon preventing its extension ; particularly if the 

 inflammation be extensive or deep-seated. Constitutional 

 remedies are peculiarly available, because the mortified parts 

 are already dead, and no topical applications can restore 

 them : the constitutional means of this nature are such as 

 tend to strengthen arterial action, as it yet remains exhausted 

 or disturbed. These ends are best fulfilled by drinks com- 

 posed of sulphuric ether and laudanum, an ounce of each, 

 the liquor ammonite acetatis six ounces, and cold water one 

 pint, frequently repeated. If the debility be already ex- 

 treme, we must employ more active tonics, as bark, the 

 chlorides, camphor ; in conjunction with the foregoing, and 

 porter, ale, or gruel, as beverages. With regard to medici- 

 nal tonics and cordials, they should be frequently adminis- 

 tered, that their action may be uniform and permanent. 

 Local applications are to be made use of also ; not with a 

 view to restore the parts already dead, but to prevent the 

 spreading of the evil, and to assist the separation of the 

 sound from the unsound. The fermenting poultice, here- 

 after to be explained, is a useful application ; and occasion- 

 ally the parts may be washed with the chloride of zinc. 

 Scarifications over structures, in a state of gangrene, may be 

 freely made, but they must be circumscribed by the extent 

 of the diseased surface ; and they may be more than skm 



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