GANGRENE. 
its cuticle and to change colour, it is a daa with mas 
to fearify immediately ; here, as in the preceding inftan 
if the {carifications be too a ee they saute be uel ; 
if they be fo deep as to caufe a flight hemorrhage, an 
reach the parts which have not er loft their fenfibility, they 
mutt do what indeed they aré generally intended to do, 
is, give the = — fhall be applied, an aac 
7 a acting on 
he fie mott ft fre quently made ufe of for this pur- 
ete are, like the theriaca, ee for this Fe ie activity 5 
and confift of the ite te ei oils a ams, whofe 
actions muft neceffari o itimulate aaa irritate t from 
thefe pealiaes they ae r puis excite pain, which, ac- 
eording to my idea of the dileafe, is diametrically oppofite 
to the proper curative eae 3 and this L am convinced 
of Bei repeated exper 
e dreffings onal confift of materials which are too 
foft and enn nor are any fcarifications neceflary for their 
applicat But I would go farther and fay, that fcarili- 
cations are not only ufelefs, but, in my opinion, prejudicial, 
bye ae he the great and chiefly to be dreaded evil in 
this com pla The poultice fhould be alfo foft, {mooth, 
and unirr aes 3 its intention fhould be merely to foften and 
relax ; it fhould comprehend the whole foot, ankle, and part 
of the ee and fhould always be fo moift or greafy as not 
to be likely to become at all ce or hard between one drefling 
and another. 
«© I will trouble the reader with -only one remark 
n the toeéare, to all z appearancé, ng el morti- 
aes 
thus produce ’. bing on frefh 
e pee enous 
f the eat i well, oe cae will certainly drop 
of; 33 if he do arife from’ temoving them.” 
“ing diarrhcea. 
nd thought, that when opium is prefcribed, = 
r. Kirkla 
medicine fhould not be pufhed a — as - believesmo oré har 
aes ufed afoft linfeed poultice ora fimple p 
tients Ferseaies under thefe c pices ts. 
ave only to add, on the {ubject of the internal treat- 
ment or mortifications, that, in all thefe cafes, a good fup- 
nd ftri€teft. obfervance of cleanlinefs 
cernin 
gt 
a may very well be noticed in fpeaking of re topical 
haa treatment of Gangrene and Peon — There can be 
no doubt that the extent of the deftru@tion about to také 
lace in the parts during the gangrenous ftage ma 
confiderably influenced by the kind of treatment purfued at 
this period of the diforder. i i 
tioner, above all things, to find out, if po 
the mifchief, and, if he can, remove it as: fpeedily as poffible. 
oe when the olay oie, appears to originate from violert 
ufe every means in his power t 
ftill alive, and on the point of b 
treatment, like the conftitutional, ought 
ftances to be of the antiphlogittic pan ae 
not wt is applied‘to fuch parts as are already dead ; but : 
is of material confequence that ane irritating be: put o 
thofe which are living and ina high itate of inlammation. 
fhould be inclined on principle to ke ufe of cold ap- 
plications in preference to warm ones, i ie dhs lotio. 
aque lithargyri acetati is as good as any oth 
Mr. Hunter was of opinion that all ae lea applications 
fhould be cold ; but we know that there Ctitioners 
em. It is a fae whic 
warm. emollient. apphcations 3; In 
ones. . 
n the furounding inflammation is at an end, and the 
mits of the mortification are fixed, a foft linfeed poultice, 
ens ee Niet ed charcoal, is an excellent applica- 
o 
5 
We have advifea the furgeon to endeavour to difcover the 
remote caufe, and remove it if pofible. When the diforder 
is owing to preffure of any kind, nothing avails without 
removing the occafion of the floughing, and even -fuch re— 
moval may be too late to. a of much fervice. In this in- 
Itance the chief means of pre Saige an increafe of mifchief 
parts which are affected. 
edget, asa to- 
application, ae h fome furgeons ae bits of lint. 
dipped in {pirit of w 
andages tact aes occafion gangrene, and we 
need hardly fay, that their removal is the very firit indica- 
Violent inflammation and gangrenous fymptoms are fome- 
times th of the expofure of the parts affected 
hefe evils are particularly apt 
armed, Ex- 
to certain degrees of cold. 
to follow when the parts have been fuddenly w 
perience has repeatedly evinced, that caloric pene — 
be communicated to frozen parts very gradually. 
when a part, which is not aaa frozen, but ce ae 
cold, 
