ULCERS. 775. 
by the opening of the synovial sac. In cases where the fissure of separa- 
tion is very deep, the pus abundant, and its escape difficult, several 
incisions may be made to relieve the difficulty. 
With most gangrene, as with the preceding, the work of defining and 
eliminating the eschar must be trusted to nature. Interference here 
should also be limited ; assist the work of demarcation and prevent 
with disinfections the accidents likely to follow the putrefaction of dead 
tissues. ‘The wound should be frequently washed with antiseptic solu- 
tions (strong preparations of carbolic acid, creolin, chloride of zinc or 
of lime, or of permanganate of potassium) ; thus, the odor from the 
putrefying tissues will be much less marked. The powders of coal or 
of coal tar, thrown upon the mortified parts and into the fissure of the 
slough, will also diminish this odor very much and absorb the gas 
escaping from the decomposing tissues. As soon as the eschar is loose, 
its superficial layers can be cauterized, or excised with the bistoury or 
the scissors, being careful not to touch the sound structure. If pain is: 
severe, the inflamed tissues should be covered with boricated or iodo-. 
formed vaseline to which cocaine has been added. The antiseptic: 
washes should be applied frequently until the wound is covered over its 
entire surface with granulations. Incisions along the edges and counter: 
openings are more dangerous in this than in dry gangrene; they would 
better not be made unless they are urgent, and then they must be 
made with the actual cautery. 
Diabetic gangrene (dog) receives the same local treatment as the moist 
form. Besides this, an antidiabetic regimen should be instituted (meat, 
milk, exercise), with the internal administration of antipyrine, alcalines, 
and arsenic. 
Iv. 
ULCERS. 
In a general way, all suppurating wounds, without tendency to cica- 
trization, deserve the name of ulcers. Glanders, tuberculosis, carcino- 
sis, and scurvy give rise to symptomatic ulcers, simple accidents of the 
infections to which they are related. 
The group of zdtopathic ulcers has been considerably reduced by the 
progress of pathological anatomy. It only contains now ulcers from 
“ unknown causes,” and seems condemned to disappear soon from the 
nosological list. These ulcers are the consequence of arterial, venous 
or nervous lesions, which reduce locally the resistance of the tissues 
and seem to be under the influence of diathetic states, especially of 
arthritism. They are less frequent in animals than in men. 
From the surgical point of view, we will recognize : 1. Luflammatory 
