1000000031

gery,

tllat

evacu2tions are pernicious in every circum{t"ance

ól

difeafc, which is

Jan

cad

in fuppuration:

BUl as

phyficians do now acknowledgc, that blceding on cutain

occiolÍi",os

tbe fmall·pox, is

DOl

only

impcdiment to

lhe

maturatioo,

bUl

e.ven promotes it

fo in lhe

formadoQ

abf~"efres,

when the ve/fel.

h.ve

beco

~Iogged.

and the fup–

puratioD ha. not kindly adv.oeed, bleedmg has fometime'

quickcDCd it

accoydinglYi

but, however, tbis praélice is [abe

foJlowed with

cauti~D

. .

Purgc,

are,

doulu,

improper

at thi. time; yet if the patient be eoRive. he mu(l be at!ilt–

ed with geode dyllers ev:ry two or three days.

Of all [he applicatioos inveoted

promote fuppu_ration,

tbere are none fa cafy as poultices;..

bUl

as there are particuJar

tomaurs very Oow

or.

ftsppuratioo, aod

almorl

void of paio

(fuch. for inUanee,

a.re

fome of the ferophulou. fweJli.g.) i,

wilt be lef. troublefome in thefe eafes tO wear the gum-pla–

{lers, which may be renewed every

fOUT

or 6ve days ooly.

A mongtl [he fuppurative poultices. perhaps [here

is.

none

prefe,.ble tO that

m.de

of bread and milk foftened with oil;

lean the advanuge

of any

oeher

Qver

is out to

be di·

í1ioguifhed iD praéliee. The abreef. may be eovered with the

poultice twice a.day.

tiJI

come to

[hu

r'peners as to re–

quire openiog, whieh will be koowo by .he thinnefs and

eminence of the íkin in foroe part of

¡t,

a Oulluatioo of [he

tnatrer) and, generally ípeaking,

Oln

abatement of the paio

prc\';ous. la lheCe appe.uances.

• T ne Ggos of a gangrene are

lhefe : Ihe

in8ammation lofes

lts redoefs, and becomes dufkilh and Jivid ;

the

tenCencCs of

.he Ikio goes off, and feel$ tO the ,oueh Oabby or emphyfema–

taus;

vcGcations

filled with ¡char of dlfferent

colours

{pread

aJl~ove r

lhe tumour

fubfides. and, /

from a dufkifh

com o

plexion,

tu~ns

btack,

IftC

putre

quickens and links, and pro–

f~fe

fweats eomiog on, at laft grow eold, aod the patien'

dI".

To (lop the progrefs

a morti6cation, the method of

treatll)em

~ill

be nearly

the rame, froro

whatever

caufe it

procc:ed, except

in that arifing

from cold; in which cafe,

we ought to be

cauti~us

not

apply warrnth

too

fuddenly

the pan.

it be

Hue.

thar

the Donhern countdes [hey

h av.e

daily con,itliOD of gaogrenes· produced

(his means,

",hleh might have been e. fily preveoted by. avoiding heat;

nay, ,hey carry tbeir apprehenfioo of the danger of fodden

warmth fa

fú

as to cover

the

pan

with

(now firfi'. which

they fay

f~ldom

hils tO

obvi.te

any ill eoofequenee.

The

pratlice

fcarifyiog'gangrenes,

Iv;

feveral

ineifions,

almofl

Uf'Iiverf,¡} :

;;!;nd with rearan; fince it

n~t

only

fels

the parts

free .

and

difcharges

pernicious

ichor,

bu{ makes

way for whatever efficacy there may be

topical appliclti ,

O?S, .

Thefe are difFerent

with di ffcrem

fUI'geons: bUI th;:

d'gelllves foftened with ,oil

turpentio.e are as good

drer.

fings as any

for

lhe

fc.!.riri cado"s .

aod

uoon thcnl all

ov~r

the pan.

may be

~.t;d

(he

theriaca

't.()ndin~nj;'.

whlch

fllould

be always ufed in tbe begian.ing

gan~rene',

before

the

neceffity of fcarifying ari{es; or what

equally

good,

noc

often

preforable,

a caraplafm

rnade

\\ith

J.xivÍum

aod

bran, aod ;:¡ p¡tlied

waqn,

which wdl rClain its heat better

th;:¡n

mon

other topicéils. Medicines

aha

giveo ín ternaJly

are

b~ne~ciat,

el'

thefe: fhoulá confi!l or rhe r.ordial k,-Ind ;

but

th~

bark

the fovere'grt remed)' for

(his'

dif. lrder: af..

ter

the

fcparation

of the efchar, the wou nd becomt:s a' com o

mon uleer, and

mua

ue3ted :u'

fu eh.

. There

are

t~vo

W'd ys of

openíng an

abfc::r~ ;

either

in·

<Iúon, Or caunlek

but ioeiuoo is prefer;¡!Jle in mo(l eaC.,.

In fmall abfeell"es, there is feIdom a neeet!ity for greater

dilat~tion

than a

Jiule

orifice

made

with the point

a lao–

cet ; aod in large oqes, where (here

not a

greu

quantity

lkio difcoloured aod become thin,

inci(ion"'1:o

their

ut–

mo(l eXten, will ufu.lly anfIVer ,he purpofe; or if there

be moch

thin

difcoloured

O,io, a

circular or

oval

piece

óf ir

mufl: be

cut,

away;

which'

operatioo,

if done dexteroufly

with a knife, is ",ueh lef, ·paioful th. o byeaufiiek. aod at

once I.y' open a gre.t fpaee of Ihe abfeefs, wbieh

m~y

dr.etred down tO the bouom, aod lhe matter of it be freely dif–

charged

whereas.

after a caullick, {hougb we

ma~e

incifi–

oos thróugh the efehar, yet the matter wíll be under fome

confinement: and we cannot

hav~

the advantage of qreffiog

properly

!ill

the fel'.ratioo of the Oough. whieb often re–

quires

conGderable

time,

that the

cure

muft be neceC.

farily del.ayed; bofiae• .tha, Ihe.

p.in

of buroing eonliou–

ing two

three

houu,

'which

cau1lick urualfy

require~

doing

in ofllee,

draws (ueh a flultion

upon

the

Ikl.n

rouod

the eCchar, as

fome times

¡ndifpore

it very much

for

heal...

ing

afterwards.

the ure of cauClicks, it

bUI

toO much

a praltice. toJay

Cmall

one'

the

roan

promiDent

pan

a Jarge

tumour,

which Dot givisg rufij.eient vent to

the

mat–

t~r,

aod

perhaps

the orífice foon aE¡er

growing

narrow. leads

on to

the neceffity

of employing

teots;

which

';'0

eircum–

(laoees more frequently ·make finulas .fter ao abretfs, thao

aDy malignity in the oatúre of the abfeefs itfelf .The

even~

wouJd more

cert.ainly·

be the Carne

after

a fmaJl meiúon ;

but

furgeoos oot.depeodiog fo mueh on fmall openiogs by inei–

fioh. as by eauOi·ek, do. ",hen they ufe the knife, genera)..

lydilate fufficiently' : ' whereas, in the

other

way, a

liule

o·

peoing in ,he mon depending par! oí the tumour ufually fa–

tisfies

them ,

From !bis aeeouot of the method of opeoiog .bfee(fes, it

does not ap·pe.r ofteo Deeetrary to apply eallfiieks; ye, they

haTe their advaDtages in fome rerpeéls, aosi are feldom fo

terrib1e

piltients as

the

knife, though in

faét

they are

(re..

queody more painful

bear. They are of

mo(!

ufe in e.feo

where the

/kíñ

thin alid

infbmed:

aod we have

reafon

think

the

málignity of

the

abrc:f~

is of

that

n~ture

as to pre.:

vent a quicknefs of

incaroine;

in which circum(lance.

¡ncifion

only

\Vere

made

through

t~e

lkin• .

Jiule

finufes

would

Orten form, and buri'ow unácrneath. and the

fips

of-

Iy–

ing (ooofe and ftabby, would beeome eallous, and r«ud

lhe

core,

though

the

m:alignity

the wound

were correc·

ted :

of t!lis

kind, are \'t nercal

buboes,

wh ich

norwithlhnd–

íng

they 'often

do well

.by

mere

¡ncifion,

yft

when lhe fl.:in

is in lhe llate

hav-c'

fuppofcd,

,he cáuíbck

ahvays prc:·

faable:

but this melhod (hould be

confined

venereal

bu·

boes; for thofe which follow • fe..

er,

or ,he fm all-pox, ·for

the

mofi

pan are curable by

in~"¡(¡on

oñly. There ate many

fcrophulous tumours ,

where

the

reafoning is the

fame

the'

venereal

3"d

even

great

fwelliogs.

iflhe

pil tient

will

not

fU~Jmit

cutting,

and

the

(urgeon is ap·prehenlive of

an~ danger

in,

wounding a

large

veffcl .

whi-::h

onen done

with

the

knife,

yet as

this

inc()Qvenience

is avoiJ cd

can–

fiick, it'may

fu ch an

oc~fion

made

ule

of;

hcwever;

ferophulous fwelling.s of the neek and f. c<, uolofs they

are very

large.

caufiícks

are

not 2d \,¡feable, linc<: in lhat

PUt of the body, with leogth of ti me. Ihey hc. 1 after in–

c~fion.

Caufticks are of grtat ferY1ce in

derlroying

Hubborn

fcrophnlous indurations of the glancls. airo venereal ¡ndura–

tioos

lhe

gh,nds

{he groj o, \\ hidl will

neil!J er

difcl.fs

nor

fupp,urate

j '

likewife in expo!!og

ca¡:.ioLls

bones; <ln""

ma!U!1&;