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making h rge itrues. T he bdl ~au!lick in ufc: is a par.e maJe!
widl lime ana lixivjum capiJa/e, which is to be: prevemed
from fp reading. by c\luing <In orífice in a piece of (lickiog
plaifler, nearly as big as you me~n to make the erch;¡,r ;
whieh be:ng.applicd to the part, tbe eaullick mu/l be laid
00 Ihe onli .:e, and prefcrved iD its fitualion by a fe", U'ps
of plaifler round its edgeo. aod a large pieee over tbe
IIIhole. "¡heo ilfues are made. or hooes expofed. tbe ef
ehar fhould be eUI out immediately. or the oext day: for
ir \Ve \Vait the (~paralÍonJ we mifcury in our dtfigo of ma–
kiog a deep - opeoiog; fince Ooughs are /luog dI' by the
fproutlng new flt:fll undernecath, which fiJls up the c.,vuy al
~ht! f:sme time: that ü difcharges lbe ~fchar ; fa that we are
obliged .fterwards to the openiog a feeo od time ,IVith
paioful efcharollek medieioe.. To ao ilfuc. or lay a
bone bare, Ihis cauCli::k may lie on abo~1t four hours; to
de(lroy a large . fi'e or fix; aod to o~eo abfe¿ffe.,
en hOllr and a halt, tWO haurs, or three hours, accordlng
( O {he thickneCs of the fkin ; and .wh:n is very lemarkable,
notwithfl. oding lIS flrength aod fuddeo ellieaey., it freque ot .
)y gi ves 00 paio whére tbe Ikio is Dor io6.amed, as in makin¡
jlfues. and opeoiog fome fe w abfeelfes.
Wheo ao already burfl. we are to be guided
hy the probe where ~o dil.... obferviog the fame rules with
regard to lhe dc~ree of dilatatíoD as in the other cafe, The
. fu. l method of d ilating. is with the probe_feilfars; aod io–
dced. io all abfeelf<S'. the geo<rality of furgeoos ufe the
{eilf." , after haviog 6r(l made a punélure wilb • l.ocet :
h ut . s th. knife operates mueh more q Ulckly. aod " itb lefs
violence to tbe p:úts. tban rci{fars, which fqu~eze at the rame
time lhAt lbey wouDd, ir will be {pariog the pa.tlent a ¡
deal of pain lO uCe the kmfe, W"here_ever ir is pr:téticabJe,
which-is in almoR all cafes. except fome flfiula 's in ano,
where the fciJTars are more convenient. T he manner oE
opening witb a knife, is by lIidlng it on a direétor, the
groove of which prt'vents lts beiDg ruífgulded. If the on6ce
of the abfeefs be fo fmall as not to admll the direaor, or
the blade pf Ihe feilI'ars, ie muO be enlarged b)l-' pleee of
{pooge:«ot; whieh IS made by dipp1ng a dry bit of (pongo
jn mehed wax, and immediately fque:tZlDg as much out of
it agaio as poffible, betweeo t wo pieces of tile or marble;
th< cffea of \Vhieh is. Ih~e Ihe loofe fpuoge beiog eompref.
fed into a fm:\1I compafs, if any of it be iotroouced mto an
abfcefs, the he.t of lhe pan mehs down the rem~i ning wax
lha t holds it together, .aod the fpooge fu ek,ng up Ihe moif·
ture of the ..bfce(s, expands, and in ex pandlOg apeos the
ori~ce wider. and by degrees, fo as to givc ver)' little paio.
The ufual method of drdline an abfcefs. the ro rfl lime.
is with dry Jint only; or ir there be no fl ux of blood, with
{oft digefliye, fpread 00 liot. I~ there he no d . nger of >he
upprr part of lhe wound reuniting'too foon , lhe dollils mult
he Jaid io loofe; but if Ihe abfeef. be dcep. ~nd the wouod
nurow as is the cafe Cometimes of abfcc{ft:s in anD, the
Jinl mull be cr,.mmed io pretty ughtly, thu we may h;ne
afte rw;:¡rds (he ad,·antage of dreffing down to the bottom
without the ure of tenIS, whicb, by reúfling the growlb of
the littJe greoulatloos of flefh, in procef~ of time harden
Ihem, ¡od in rhat manner produce 'ól finuJ a ; fa tbat . inll ead
"f b'iog ufed for Ihe cure of ao ab{eefs. they oever Chould
be e:mpl" y~ d I)ut whcre we mean lO retard the healing of
Ihe e:x te:n.d wound, except ~n fome liule narrow abfcelTts,
whue. if liwy be nOl crammed in too largc, they b('rbme
z. dO¡¡¡IS, ad.mitting of inearnatien ae the hotloDl ¡ but care
G E R Y.
fhould he tokeo. nol to Ihem mueh deeper Ihao
the !km 10 (his care, and thar (hey fhould be repeated twiee
¡ ,day, t~ give vent to tbe maucr ¡bey confine B'H teotl
do mon good iDliule deep abfcelres , whence aoy eXU30C.()US
body is to be ev.. cuah::d. ruch elS (mall Cphnters of bone, Oc.
\'be ufe of vuloe..ry inj. aioos into abfeelfes has beeQ
thought tO bear fo near a retemblance to Il\c ufe of teou,
th.u they both fell ioto dtfrepu\e almon at the (ame time.
O ver ,he dt'(lil, of 11m may be latd a I"ge pledgi t of lO,,"
{pr<.d Il'IIh b,filicon. whicb wdl lie (ofter th.o a de(eof••
t¡ve plailler; for (bis, though deligned ro defend lhe cir–
c.umference of wouods againfl: inH.mmation or a fluétioQ of
humouu, is ofeeD the very caufe o( lhem ; fo lhat Ibe dref–
fiog. <if large wou Dds Chonld never b< kept 0 0 hy tbefe
plailtera, ",'here [bere ¡, danger o( fuch accicieots," In [rus
manDer, Ihe drefliogs may be condnued, tíll th~ cavity il
iocuned ; and theo it may be cicatnfed witb dry , or
fome of the cicatnfing OIl)tme~tS, obferviog , to keep (be
funguJ dowo. as di«éled before.
lo Ihe eourf" of drefling it will be proper ID have regard
lO the fitu~ttoo of the .bfeef. and as mueh as poflible to
Ihe p..ient favour the difeharge by hlS ordioary po–
(lure: aod tO thi, end alfo, as what is of greolter imporlance
thao the virtrJe of any ointment, the difch"rge mufi be: ar–
úfled by eomp'ref. aod baodage: the eomprefs may be made
of ngs or plalfier ; though the latter 1S fOme times prefera.
ble, as it-remains irnmove:able on the part it ¡s Ólpphed to·.
T he frequeoey of d tefli ng wtll depeod on the quantity of
difcbarge: once in twenty.four bours is ordinarily fuJlicient ;
but Cometimes twic.c, or perbaps three timcs, is oecelfary.
°fULCHS.
WHEN a wound or abfeefs degenerates ioto fo .bad a /late
as to r.fiil Ihe methods of curo above laid dowo . and lofes
that compleétioD whlch belongs te a heaJing wQund. il is
c.llled an ulcer ; and as tbe name is generaJ!y borrowed
from Ihe ill habit of Ihe fore. it i, a euftom tO .pply il tO
all f(lres Ihat haTe aa y degree of m. l . thoogh hey he
immedi.ttely d wilhoul aay pn:Vl0US ...breefs or wouDd ;
fuch art: the venere;¡J ul t'ers of the lonhls, ec,
Ulcers are diHil'lg01Jhed by th\," r pAnicular diforder!;
rhougb I ( ftldom happens that rhe ,.ff.{tions are nOI compli~
cated; liad when we lay down rule~ for ,he managt>me t of
one,fpe:c, es of ulcer, It 15 géner all y rt>qudite ro apply them
tO alfllolt all others H owevc:r. ' he char.H~ter, o! moH emi·
Dence are,\the caUou~ uIeI.'r, .th~ finous ulcer. ¡.¡nd {he ukcr
with caries of the adj Icc:nt bone: tho' {here be abund ...nce
more known to Curgeons, fuch dS [he putlld , Ih e." corr ..fi,e,
lhe vétricous, &c bur as lhey have clrq uired lhel r n.. mes
from lome p.trucul..r afF~éhon . we (}ull fpeak of thetreatmeot
of Ihel)1 under lhr gen::rdl head of uke rs
11 wd) be oftcn In to purfu e lh\ bcll mean5 o( "ur(' by
tapical applic..tion, unlefs we are .. lIifled b;'l inlernal n 'me·
dit:'s; for as motny ulce:rs are the ef[ 8 5 o f a Pdrticular in·
dtfpofi tlOD of bod y it will be dimcult ro brin)! rh~m ¡nro
order, while {he cauf( of them rernains with any "ioJt nce ;
thollgh they are fom~l mes in a grea degree rhe d,fcha rge
of Ihe indifpofi,ion "f<lf. as 10 the plague, f", ..!I. pox, &c.
B " l we fee it W'oerally necclTHY in Ihe pox. the fcurvy.
ob(truélions of the menres droplifs, and m.lny othe-r di–
fl empt rs, te give :ntern.tls of gre;u efficacy: and indeed ,
there are h<t rdly ¡j n~' car'!lhtUtions wlJer~ uJcers are not af.
lifled by {om" phyG,,' regimeo. T hofe ehat are eaneeron.
aDd