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AN ESSAY ON THE MOST EFFICACIOUS MEANS OF TREATING ULCERATED LEGS.

IN WHICH The topical APPLICATIONS in general Uſe ARE CONSIDERED, AND Some new METHODS for RELIEF propoſed; WITH PARTICULAR OBSERVATIONS On the SAFETY of HEALING OLD ULCERS.

LONDON: PRINTED FOR THE AUTHOR, AND SOLD BY W. NICOLL IN ST. PAUL's CHURCH-YARD.

MDCCLXXXIII.

[PRICE ONE SHILLING.]

AN ESSAY On the moſt efficacious MEANS OF TREATING ULCERATED LEGS.

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WHOEVER has been at all converſant in the practice of Surgery, or has attended an Hoſpital, muſt have frequently obſerved the difficulty of healing an ulcer in the leg, which even when the patient is young, and appears of a ſtrong conſtitution, often for a conſiderable time baffles the moſt attentive efforts of the healing art; but when the ulcer is of long ſtanding, and the perſon a little advanced in life, it too frequently not only eludes every endeavour to effect a perfect cure, but is with difficulty brought to that ſtate, ſo as to be but ſlightly painful, and in a ſmall degree inconvenient. It is likewiſe not unfrequent, if the conſtitutional fault, which [4]diſpoſes to aggravate and continue this diſeaſe, is not properly removed, although the ſurgeon ſhould be ſo ſucceſsful as in appearance to heal the ſore, that on reſuming uſual exerciſe, in the courſe of a few weeks, the part becomes daily more painful, the tender covering appears ſlightly tumified, and ſoon breaking, a ſore again appears, that from its ſituation is liable to be aggravated by the ſlighteſt injury, to which patients of this claſs, from their neceſſary avocations, are generally ſubject: the greater number of theſe unfortunate ſufferers being thoſe, who are neceſſitated to procure their ſupport by labour or ſervitude, but who, whatever inconvenience they experience from the ulcer, ſeldom, till after uſing for ſome time different cerates and ointments, and ſometimes even irritating dreſſings, apply for ſurgical aſſiſtance. This aſſiſtance often falling ſhort of the wiſh of the practitioner, and expectation of the patient, has induced me to ſuggeſt the few [5]following hints, which have occurred from an opportunity of ſeeing a large number of theſe unfortunate caſes; ſincerely hoping, if thereby only a mite is contributed to the public benefit, by exciting more particular attention to this ſubject, thoſe gentlemen who are truly eminent in their profeſſion, may favour the public with ſome more certain and expeditious mode of removing this diſeaſe; the treatment of which now remains in ſo imperfect a ſtate, and gives ſo dark a ſhade to the general lines of Surgery*.

We will firſt ſuppoſe an ulcer of but ſmall extent, its appearance what is uſually termed clean, the edges thin, with little or no calloſity, and the ſurrounding parts but ſlightly diſcoloured: the uſual dreſſing in this caſe, is dry lint, immediately on the ſore, and over this a plaiſter of calaminaris cerate, [6]which extends two fingers breadth every way from the edges of the ſore, over this a bandage; on removing this dreſſing once in the day, the lint ſhall appear covered with thick white matter, the pain, which was at firſt but ſlight, go off; yet the ſore frequently heals but very ſlowly. To what cauſe are we to aſſign this ſlow progreſs in healing? Is there ſome conſtitutional fault, or are the dreſſings the moſt proper? If the fault was entirely conſtitutional, may we ſuppoſe the healing would not have thus far advanced? Yet how can ſuch mild applications be improper? Is the conjecture improbable, that the plaiſter of the ſize before mentioned, (which is conſtantly applied) by retaining the perſpirable fluid, keeps the cuticular veſſels over which it is placed, in too relaxed a ſtate? and if this be the caſe, would not a compreſs, wet with vegeto mineral water, or any other mild aſtringent liquor, applied three or four times a day over the lint, ſooner heal the ſore, [7]when advanced to this ſtate? It may be urged ſuch ſore uſually heals by the uſe of lint and cerate; but the time, often more than a few weeks, neceſſary to effect this, is certainly too long to ſubject our patient to an inconvenience, provided any quicker, and equally ſafe mode can be propoſed.

This is the moſt ſimple ſtate of ulceration. We now conſider an ulcer as in a foul ſtate, with a thick callous margin, a thin irritating dark coloured diſcharge, and the ſurrounding parts to a conſiderable extent inflamed, attended with much pain. The uſual mode of treating this kind of ulcer, is to foment the part twice a day with flannel wrung dry from a decoction of wormwood, chamomile flowers, &c. then apply ſome terebinthinate digeſtive ſpread on lint, immediately on the ſore, over this a large plainſter of yellow baſilicon. Sometimes a common bread and milk poultice only is applied, (which ſhould be renewed at leaſt three or [8]four times in twenty-four hours) but which ever of theſe means are uſed, the foulneſs of the ſore in a few days is uſually much removed, the diſcharge wears a better appearance, and the naked fibres appear of a more florid colour; yet ſtill the calloſity of the edges continues as in its firſt ſtate, and tho' the pain is leſs, the ſurrounding parts wear nearly the ſame appearance. If the bread and milk poultice has been applied, it is uſually diſcontinued when the ſtate of the ſore is thus altered, and either dry lint, or lint ſpread with ſome digeſtive ointment, is applied over the ſore once or twice a day, and this covered with a large yellow baſilicon plaiſter. To remove the calloſity, a ſmall quantity of ſtrong mercurial ointment, daily rubbed on the hardened edges, is by ſome much recommended; but as the abſorbent veſſels in parts thus hardened, may be conſidered almoſt impervious, we have no good reaſon to expect this will effect any [9]conſiderable alteration. A cataplaſm of figs, beat fine with a little honey, ſpread thick on lint, and applied on the edges of the ſore twice a day, ſo as to cover rather more than the calloſity, by its ſoftening quality and action on the contiguous ſurrounding parts, would probably effect a more ſpeedy removal of the hardneſs. But if after applying this cataplaſm for ſome days, the edges of the ſore appear in nearly the ſame ſtate, it will be neceſſary to rub them with lunar cauſtic either once a day, or every other day, in order to deſtroy the calloſity. It muſt here be underſtood that the patient uſes every endeavour to enjoy the advantage of entire reſt.

This ſtate of ulceration being generally conſidered as attended with ſome conſtitutional fault, while the means to heal the ſore are employed, ſome medicine is uſually directed to be taken daily. If there is no reaſon to ſuppoſe the diſeaſe connected with the venereal virus, or a ſcrophulous taint, it is generally called [10]Scorbutic; not as the term is connected with the ſea ſcurvy, but that general appellation uſed for moſt kinds of eruption, diſcolourations of the ſkin, &c. The medicines uſually given for this purpoſe are Aethiop's mineral, cinnabar of antimony, &c. Aethiop's mineral has, by being long in uſe, obtained credit with ſome, as a remedy capable of effecting great changes in the conſtitution; but when it is conſidered that ſulphur joined with mercury almoſt entirely deſtroys its active qualities, little good can be expected from the adminiſtration of this medicine. Indeed we may venture to aſſert, the efficacy deſired is ſeldom if ever obtained. Cinnabar of antimony, as a compoſition of a ſimilar kind, may be ſuppoſed to have no better effect. Nitre is another medicine ſometimes adminiſtered; this poſſeſſing a ſedative quality, often powerfully abating inflammation, and acting, in a proper doſe, as a diuretic, is doubtleſs in [11]many caſes an excellent remedy. But other qualities ſeem to be wanted for the cure of this kind of ulcer. Calomel likewiſe, which is ſometimes given in a ſmall doſe for three or four nights, and then worked off with a briſk purge, tho' frequently repeated, generally fails of producing the beneficial effect required.

If the conſtitutional fault now treated of, be a too impoveriſhed and acrimonious ſtate of the fluids, and from hence diſpoſition to relaxation of the muſcular fibres, the conſequence, we have a moſt noble and almoſt certain corroberant in the Peruvian bark; but this is likewiſe given to remove the conſtitutional fault, and forward the healing of the ulcer, yet too frequently, not with the wiſhed for effect. May it then be ſuppoſed, tho' this invaluable medicine will give tone to the relaxed fibres, the fluids are not brought to that balſamic ſtate neceſſary for completely healing the ſore? Therefore, while we adminiſter [12]the bark, a doſe of which ſhould be taken three or four times a day, a more nutritive diet than is uſually allowed, appears in a great degree neceſſary. Half an ounce of iſinglaſs diſſolved in a pint of milk, and drank daily in ſmall quantities, would probably afford great benefit to thoſe patients whoſe circumſtances in life have neceſſitated them to live ſparingly, or on food but ſlightly nutritive. A ſmall glaſs of mountain, or any other generous wine, allowed three or four times a day, might likewiſe prove of conſiderable benefit; or ſalep* given to the quantity of half an ounce daily in a decoction of [13]burdock root, a coffee-cup full to be drank frequently as common liquor, appears likely to much aſſiſt the other means employed.

From the dreſſings daily applied, and the alteration induced in the conſtitution by adminiſtering Peruvian bark, and allowing a more nutritive diet, we will ſuppoſe the ſore is become leſs, the callous edges nearly removed, the diſcharge thicker, and the pain much gone off, but ſtill the ſurrounding parts diſcoloured; yet altho' we are thus far advanced towards the cure, after ſome days the ſore often will appear to heal no further, and not unfrequently part of the new covering diſappear, and the ſore become enlarged. Are we to ſeek a remedy, in this ſituation of the diſeaſe, from internal means? Or are different topical applications likely to alter this ſtate of the ulcer, and induce it to heal? No one will doubt the propriety of continuing, or even encreaſing the doſe of a medicine, before found ſerviceable. But are topical applications, [14]generally conſidered, ſo uſeful as there is reaſon to believe they would ſometimes prove, at leaſt are they attended to with that care which in ſome caſes they perhaps deſerve? Dry lint on the ſore, over this a plaiſter, is the uſual application when the ulcer (however deep) appears clean; but may not the plaiſter in this caſe produce the ſame inconvenience as before alluded to? And may we hope ſome other application, immediately on the naked fibres, will aſſiſt the more ſpeedy healing the ulcer? Slightly touching the ſore with the elixir of aloes twice a day, then applying fine dry lint, or lint ſpread ſlightly over with a mild cerate, and over this a compreſs, wet with vegeto mineral water, (which compreſs may be wetted more frequently, if it grows dry) would probably contribute much to the more ſpeedily effecting this purpoſe. Or uſing the lint and compreſs wet with the vegeto mineral water as above, after ſprinkling the ſore with a powder compoſed [15]of three parts ſaffron, carefully dried and finely powdered, and one part powdered myrrh, or with powdered ſaffron only, (which I have reaſon to believe, poſſeſſes a vulnerary quality, hitherto but little attended to) might much aſſiſt our attaining the deſirable end—a ſound and compleat cure.

In the ſtate of the ulcer, as at firſt deſcribed, the pain will always make our patient ready to comply with our requeſt, to reſt the limb as much as poſſible; but when the ſore is brought to a leſs painful ſtate, may we conſider reſt then not ſo neceſſary, particularly if the roller, which ſhould be conſtantly worn, is properly applied from the foot to the knee*.

[16]

If the danger of healing an old ulcer, is urged againſt our endeavours to generally compleat a cure—if it is remarked that loſs of appetite, pain in the ſtomach and bowels, aſthma, and other ill conſequences have been obſerved to follow the entirely ſuppreſſing a diſcharge from the leg, that has been of long continuance; may we ſuppoſe (as the proceſs of healing is uſually ſlow) that careful attention to the ſtate of our patient's health, particularly when the diſcharge is much leſſened, will enable us to judge of the ſafety of perfectly healing the ſore, or direct us only to continue our endeavours, until it is brought to ſuch a ſtate as to be but ſlightly inconvenient. When the healing is far advanced, and after an iſſue [17]made in the thigh has diſcharged freely for ſeveral days; ſhould our patient frequently find pain in the ſtomach and bowels, which although relieved by a mild purge, or other proper medicine, ſoon again returns—ſhould ſhortneſs of breath, or particular laſſitude be obſerved on any change of the weather, or increaſe of exerciſe—ſhould want of uſual appetite follow, or nauſea often recur; may we not conſider theſe ſufficient indications to deſiſt from the conſtant uſe of healing applications, and in their place ſometimes apply immediately on the part a little mild digeſtive ointment ſpread on lint, in order to continue the diſcharge and keep the ulcer in ſuch ſtate as to be but in a ſmall degree inconvenient. On the other hand, if as the cure advances no difference is obſerved in our patient's ſtate of health, but what is rather for the better, may not our endeavours to completely heal the ſore be ſafely purſued? Which if we are ſo happy to effect, [18]leaving an iſſue in the thigh, to be carefully attended to for ſome time, will make us eaſy reſpecting any future conſequence.

Could we in every caſe of ulcerated legs, have the happineſs to make a ſafe and perfect cure, what a large portion of human miſery would be removed: How many a father on whom a numerous family depends for ſupport, if freed from pain, would earn the bread of comfort! What pleaſure would many mothers find in performing the neceſſary taſk of care for their, perhaps, yet tender offspring: Or, ſuppoſing the parents free from what would be their pride, in beholding their children in the full uſe of their limbs! If I appear too earneſt, the importance of the ſubject, I hope, will plead in my excuſe, this diſeaſe too frequently at preſent, like a ſable cloud ſpreading a gloom over the field, ſo ſplendidly enlightened by the many modern improvements in Surgery.

[19]

Having conſidered the means likely to be beneficial to thoſe ulcers in the leg to which the moſt virtuous are alike liable with thoſe who are regardleſs of irregularities; as in the latter the venereal virus is often found to accompany or produce the ulceration, ſome attention to this ſtate of the caſe becomes neceſſary. If the cauſe of the diſeaſe is confeſſed we have then certain grounds to proceed on, but (as too often is the caſe with females) if the cauſe is concealed, although the appearance of the ſore to the perſon much converſant in practice, and particularly if any copper-coloured ſpots appear in the other parts of the limb, will give almoſt a certain information of the nature of the caſe, yet the delicacy of ſuch a circumſtance requires that we proceed with caution.

For the Venereal virus we have the happineſs to poſſeſs a true ſpecific in mercury, and as the mode of adminiſtering this valuable medicine muſt be ſuppoſed to be [20]known to every ſurgeon, any hint on this point may be conſidered as ſuperfluous; But with ſubmiſſion to the future conſideration of thoſe gentlemen who ſo ſtrongly aſſert the efficacy of corroſive ſublimate in the advanced ſtages of the veneral diſeaſe, I would beg leave to ſay, the reſult of my frequently adminiſtering it has rather tended to prove it very uncertain; for although external ſymptoms will from its uſe generally ſoon diſappear, and health ſeem to return, yet after ſome time the patient will not unfrequently find the diſeaſe again appear, without having the leaſt cauſe to ſuppoſe it is renewed.

The uſe of mercury for this kind of ulceration, appears indiſpenſibly neceſſary; and if half an ounce of iſinglaſs diſſolved in a pint of milk is taken once or twice a day during the courſe, It may afford great aſſiſtance.

The efficient cauſe by a judicious mercurial courſe being removed, the ulcer uſually [21]changes its ſtate, as in the manner before deſcribed; and although the degree of calloſity in theſe caſes is uſually greater, we have reaſon to hope a cure may be effected by the uſe of the ſame external means. Two or three doſes of Peruvian bark likewiſe, taken daily when the ſore is brought to a healing ſtate may much aſſiſt the more effectual recovery of health, and prove of great aſſiſtance in compleatly healing the ulcer.

Another yet more formidable evil too frequently accompanies or is the cauſe of ulcers in the leg—a ſcrophulous taint. This kind of ulceration too generally gives us reaſon to lament that no certain aſſiſtance can be found, by whatever means we attempt relief. May we ſuppoſe this evil has been more known to late generations? Or may we agree with thoſe who conjecture that the venereal virus in the parent can operate to tranſmit a ſcrophulous taint to their children's children? what more than ſingle cauſe have we then to [22]lament "That dreadful malady, the ſevereſt ſcourge with which in this life offended Heaven chaſtens the indulgence of criminal deſire*" ever was tranſplanted from American ſoil: for ſurely, adding this calamity to thoſe which formerly embittered human life, has almoſt formed a counterbalance to all the benefits Europe can derive from the diſcovery of the new world.

But let us not too darkly ſhade the ſcene— If it too frequently happens that endeavours to cure the Scrophula are unſucceſsful, in ſome caſes experience teaches the man of practice, much benefit may be obtained, and we will indulge the hope, that to ſome future age will be known that certain remedy which hitherto has been ſought with ſuch ill ſucceſs.

When an encyſted ſcrophulous tumour is formed in the neck or other part of the body, [23]we have a certain aſſurance of the nature of the diſeaſe; but as ulcers in the leg are often truly ſcrophulous when no tumour of this kind has appeared, it becomes neceſſary to enquire what peculiar appearance ſuch ſores wear, that we may not ſuppoſe thoſe of this claſs which are in no degree connected with ſcrophula, or be diſcouraged in our attempts when we find an ulcer that from neglect only is brought to ſuch ſtate that the means ſucceſsful in other caſes, are long before they produce any favourable alteration. The edges of ſcrophulous ulcers have never that degree of calloſity obſervable in other ulcers; but, on the contrary, appear lax and ſpongy; the naked fibres have not uſually ſo florid an appearance, and the diſcharge, even when the ſore appears clean, is uſually thin and illconditioned: if the ſore enlarges, it is more haſtily than in other ulcers, and the fungous appearance of the marginal fibres is invariably to be obſerved; the muſcles of the whole [24]limb when the ulcer has been of long continuance likewiſe appear much relaxed.

That the lymphatic veſſels are the immediate ſeat of ſcrophula is an opinion now generally received; that debility of the conſtitution in general, is always connected with this diſeaſe, attentive obſervation will certainly convince us: but much more I fear is neceſſary to be known before we become able to direct with certainty, our means for relief. It may not however be improper before any thing is ſaid on the external treatment, to pay ſome attention to the internals uſually adminiſtered. Aethiop's mineral, and cinnabar of antimony, which ſome writers much recommend, have been attended to with reſpect to their uſe, in thoſe ulcers uſually termed ſcorbutic; burnt ſpung much recommended by Dr. Mead in this diſeaſe, ſeems to have little better claim to our attention; decection of the woods and medicated lime-water that are frequently ſerviceable [25]in cutaneous diſeaſes, appear not to poſſeſs the efficacy here required; mercurials in ſcrophulous caſes, almoſt certainly fail of producing any laſting good effect, and the various preparations of antimony in this diſeaſe, loſe their force; even that lately ſo very faſhionable medicine, extract of hemlock, has perhaps never been found to entirely eradicate this diſcaſe, notwithſtanding the powers ſome boaſt it poſſeſſes, even of curing cancers; Poudre unique has not come much within my obſervation, but admitting a ſuperlative efficacy in this compoſition, its extravagant price muſt ever prove a barrier to its general uſe; for who in the common line of life can afford to give more than the price of gold for copper, in whatever curious form it is offered? Thoſe who profeſs a good will to mankind, certainly miſs the aim they intend, if their own intereſt ſtrongly glares in that light where it ſhould be only juſt diſcernable; but it is far from the writer's [26]wiſh to paſs an invidious comment on any one.

If we attend to the efficacy of vegitables, may the conjecture be indulged, that modern practice does not ſufficiently pay attention to the advantages to be derived from them. It appears, the field furniſhed our forefathers with almoſt the whole of the means they employed in the removal of diſeaſes; ſome will, perhaps, ſuppoſe diſeaſe was not to them ſo formidable as it at preſent often appears. It certainly is not improbable, that modern luxury ſtates our account more on the debtor ſide: but allowing this, and that chemiſtry furniſhes more powerful and ſpeedy remedies in many caſes, it is more than probable experience would inform us many now neglected herbs poſſeſs great efficacy*. Dr. Armſtrong in his account of the diſeaſes moſt [27]incident to children, deſcribing ſcrophulous tumours in the neck, &c. has a paſſage which I cannot refrain taking the freedom to tranſcribe: "For ſwellings of this kind, when taken in time, that is, before the ſkin begins to be diſcoloured, the beſt application that I have tried, is the juice of the root of ſwordgraſs, or the yellow water-flag, (gladiolus luteus) rubbed well in upon the part two or three times a day. A ſmall quantity of this juice recently expreſſed, and ſnuffed up the noſtrils in a ſhort time after, occaſions a great heat in the cavities of the noſe, mouth, and throat, and a very plentiful diſcharge of ſaliva from the mouth and mucus from the noſe, as great of the former as if the patient were in the height of a ſalivation, which continues ſometimes for two or three hours or more; and I have heard of ſome very obſtinate chronical and periodical tooth-achs and head-achs having been removed by this diſcharge, after a variety of other remedies [28]had been tried in vain. This effect of the juice on the ſalivary glands when ſnuffed up the noſe, firſt induced me to try it externally upon ſcrophulous ſwellings, and I have had the pleaſure of obſerving it to anſwer extremely well, even upon ſome tumours of long ſtanding. It has occurred to me ſometimes to try it inwardly as an alterative upon ſome ſcrophulous patients, but I have not yet done it. I muſt not forget to mention, that the larger and older the root is from which the juice is expreſſed, and the deeper its colour, the ſtronger and more efficacious is the medicine." My uſe of this remedy to ſcrophulous tumours has not been equally fortunate with what the Doctor relates, but I muſt be free to own, the tumours to which it was applied, had been of very long ſtanding.

What effect the application of vervain root in the manner directed by Mr. Morley would produce in this ſpecies of ulcer, I [29]cannot attempt to ſay; ſuppoſing myſelf not to poſſeſs the portion of faith neceſſary for thoſe who make the application, as well as thoſe to whom it is applied; yet I feel conviction of the goodneſs of Mr. Morley's heart, and the ſincerity of his intention in favouring the world with his publication on ſcrophulous complaints.

From this digreſſion, the ſubject treated on cannot, perhaps, be better reſumed than by obſerving the virtue of Peruvian bark when joined with ſoluble tartar; the doſe —two ſcruples or half a dram of each, given three or four times a day; this medicine regularly taken for ſome weeks, together with the uſe of the burdock decoction with ſalep, would probably be found to produce much benefit in the general appearance of this diſeaſe, as well as the kind of ulcer now treated on.

The common dreſſing—dry lint on the ſore, and this covered with a large plaiſter of [30]baſilicon or ſome mild cerate, is generally the whole external means employed, when the ſore, whatever be its extent, appears clean. But may the claim before urged for topical applications be again applied here? The relaxed appearance of the ſore muſt certainly beſpeak all applications of the emollient claſs improper, and direct our attention to thoſe poſſeſſed of a different quality. Elixir of aloes applied on the ſore twice every day, as before mentioned, and this covered with a compreſs wet with mindererus's ſpirit, in two ounces of which is diſſolved two drams of crude ſal armoniac, would probably prove very uſeful; or camphire powdered very fine and ſlightly ſprinkled over the whole ſore twice a day, over this ſome fine lint, and the whole covered with a compreſs wet with vegeto mineral water, might ſtill more aſſiſt the healing of the ſore. I have had the ſatisfaction to obſerve a ſore in the leg that almoſt daily enlarged, where the fibres appeared [31]pale and much relaxed, and the diſcharge was thin, ſharp and irritating, by the uſe of camphire in this manner, ſoon wear a more favourable appearance, the fibres ſoon became of a more florid colour, the diſcharge by degrees become thicker, the ſore daily mended, and with the aſſiſtance of bark, &c. internally, became perfectly well.

The wide field of medicine, I am well aware, affords ample room for propoſing many more uſeful hints than come within my obſervation on this ſubject; nor have I attempted to deſcribe ulceration in all its different appearances. The hope of inducing ſome more able hand to favour the world with a more certain mode of treating ulcers in the leg than what at preſent has come in general uſe, being what principally diſpoſed me to attempt this ſhort eſſay, if by its publication the ſmalleſt portion of information be contributed, my endeavours will be abundantly repaid.

FINIS.
Notes
*
Mr. Bell's very ingenious treatiſe on the Theory and Management of Ulcers, muſt be admired by every one who eſteems the profeſſion of ſurgery; but it is to be lamented that he has not particularly treated on the management of ulcers in the leg.
*
That friend of human kind, and excellent phyſician, Dr. Percival, in his eſſays medical and experimental, obſerves, ‘"The reſtorative, mucilaginous, and demulcent qualities of the orchis root [ſalep] render it of conſiderable uſe in various diſeaſes;"’ and that ‘"Salep is ſaid to contain the greateſt quantity of vegetable nouriſhment in the ſmalleſt bulk."’
The manner of preparing this decoction, is as follows: Boil two ounces of dried burdock roots cut ſmall, in four pints of water to three; then add half an ounce of powdered ſalep, continue the boiling until only a quart of liquor remains, which pour through a fine ſtrainer for uſe.
*
The Roller I have uſed for a long time before reading Mr. Underwood's Treatiſe upon Ulcers of the Legs, &c. was always made of thin flannel, though not formed in the manner he thus directs: ‘"The kind of roller is to be conſidered, which ought to be made of the thinneſt Welch flannel, not thicker than coarſe linen, which advantages no linen can have; it not only being ſofter, ſitting eaſier, and making no plaits on the ſkin, but is elaſtic to a very conſiderable degree. This is greatly increaſed by its being torn acroſs and ſewed together ſelvage ways (the hard ſelvage thread being firſt cut off) whereby the roller is made to yield to every motion and varying ſhape of the limb."’ Great merit is certainly due to Mr. Underwood for his valuable communications on the treatment of ulcerated legs, &c. and his candour will doubtleſs excuſe the hope expreſſed in my concluſion of this ſubject; a ſubject which I humbly conceive will ſtill admit of many additions, before perfection be attained in the modes of treatment.
*
This is the expreſſion uſed by that late elegant writer Dr. Robertſon, in his hiſtory of America.
*
‘"The ſimple herb plantain, blunts the venomous bite of the rattle-ſnake, which would otherwiſe prove mortal." Black's Hiſtorical ſketch of Medicine and Surgery.
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Citation Suggestion for this Object
TextGrid Repository (2020). TEI. 5535 An essay on the most efficacious means of treating ulcerated legs In which the topical applications in general use are considered and some new methods for relief proposed. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-6214-F