GREASE. 
653 
to infection, though its immediate cause is yet unknown. The variations 
in its method of outbreak and course suggest that it may be due to more 
than one cause. 
Prognosis. Spontaneous recovery is very rare. As with canker, care¬ 
ful and often prolonged treatment is required. The greater the extent of 
the disease, the more active the proliferation and consequent thickening, 
and the further the growth has penetrated the papillary layer of the skin 
the greater the difficulty in treatment. The dry form is most hopeful. 
When the papillae have attained a considerable size, and folds exist in the 
skin, much less can be done. 
Treatment. The condition being unquestionably a local skin affection, 
internal treatment is of little value, and the chief indications are to cleanse, 
and keep clean, the diseased spot, to rapidly remove decomposing secre¬ 
tions, or to prevent decomposition occurring. When the process is confined 
to one small spot, the parts may be cleansed, a white-hot firing-iron passed 
several times over the diseased surface, and a disinfectant applied. In 
more extensive attacks the limb may be bathed several days in succession 
with lukewarm chloride of lime solution, or with creolin or sublimate 
lotion, and the diseased spots repeatedly washed during the time the 
limb is in the bath. 
A surgical dressing is afterwards applied, containing a mixture of 
creosote and spirit (1—6), chloride of zinc (1—10), or creolin (5 per cent.). 
Lies, of Brunswick, claims to have had excellent results from the use of 
sulphuric acid. The parts are carefully cleansed, the diseased surface 
painted with a mixture of sulphuric acid and spirit (1—10, or 1—20), and 
a dressing, moistened with the same fluid, applied. A little exercise 
should be given every day; rest favours the disease. 
Dollar commences treatment with a dose of physic, and restricts the 
diet to bran, linseed, chaff, and green foods. After applying a very large 
warm bran poultice containing 2 to 3 per cent, of creolin for twelve hours 
he recommends washing the parts thoroughly with 2J per cent, creolin 
solution, and carefully drying. The application of water is afterwards 
carefully avoided, unless thick crusts form. Cleansing is effected with a 
large handful of clean cotton-waste vigorously applied, and the parts are 
thoroughly saturated twice a day with a lotion of zinci sulph. and alum 
varying in strength from 5 per cent, up to saturation point. Severe cases 
with the formation of “grapes” are vigorously cauterised with a white- 
hot iron, and the above lotion applied twice daily. Dilute sulphuric acid 
is only employed in very old standing cases. With this treatment Dollar 
has had most excellent results. Success depends on regular and vigorous 
treatment. 
Large warts are removed with scissors, knife, or, better, with the white- 
hot iron. The whole surface may then be freely powdered with an 
