384 



In my own practice I prefer a .solution of bichloride of mercury 1 

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

 grains of muriate of ammonia added to cause the mercury to dissolve. 

 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 

 equalh' as good results, will be noted the sulphate of copper, iron, 

 and zinc, 5 grains of either to the ounce of water; chloride of zinc, 5 

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

 amount of glycerine and added to 1 ounce of water, and the nitrate of 

 silver, 10 grains to the ounce of water. 



If the wound is slow to heal it will be found of advantage to change 

 the remedies used every few daj^s, for after a time a remedy seems to 

 lose its stimulating effect upon the slow-growing granulations. 



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

 tening, the tincture of aloes, tincture of gentian, or the spirits of 

 camphor may do best. 



When 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 all that 

 is needed. 



If the granulations continue to grow until a tumor is formed, which 

 projects beyond th(i surrounding skin, it should be cut off with a 

 sharp, clean knife, the foot poulticed for twenty-four hours, after 

 which the wound is to be well cauterized daily with lunar caustic and 

 the bandages applied with great firmness. 



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

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

 purating freely it will be necessary to renew the dressing every twenty- 

 four or forty-eight hours. If the discharge is small in quantity and 

 the patient comfortable the dressing may be left on for several days; 

 in fact, the less often the wound is disturbed the better, in so long as 

 the healing process is healthy. When the sore commences to skin 

 over the edges should be lightly touched with the lunar caustic at 

 each dressing. The patient may now be given a little exercise daily, 

 but the bandages must be kept on until the wound is entirely healed. 



TENDINOUS QUITTOR. 



This form of quittor differs from the cutaneous in that it not only 

 affects the skin and subcutaneous tissues, but involves, also, the ten- 

 dons of the leg, the ligaments of the joints, and, in many cases, the 

 bones of the foot as well. 



Fortunately this form of quittor is less common than the preced- 

 ing; yet any case beginning as simi)le cutaneous quittor may, at any 

 time during its course, become c(nnplicated b}^ the death of some 

 Xiart of the tendons by gangrene of the ligaments, sloughing of the 

 coronarv band, caries of the bones, or inflammation accompanied by 



