OCR Text |
Show . ls. «.42....3." 1. or immune. "3-:st When a gland enlarges, leeches are to be applied, and the part frequently bathed with tepid water; on the second and fourth day they are to be repeated ; and when the bites have healed a blister is applied with the best advantage. If,- however, the gland shows itself to have much inflammation, a blister will aggravate and increase the swelling ; and even in cases where the gland seems indolent, it is necessary to secure a certain degree of weakness in the vascular action of the part, before any thing stimulating be applied to the surface. I am very partial to the use of vomits in discussing inflamed glands. When glands enlarge from the action of cold in a scrophu- lous constitution, cold wet applications are to be avoided ; in- or rmrouns. ever diminishes the activity of a swelled gland restores the balance to the absorbents, which were previously overpowered by the activity of the arteries; for it would not be dithcult to prove that the lymphatics are less under occasional influence than the arterial system. While we endeavour to reduce the activity of a swelled gland by direct means, we must premibe purgative medicines twice a week, and enjoin an abstemious diet; temper rance is of the utmost consequence where there is danger of a confirmed scirrhus. If the gland continues-hard after this treatment, our next resource is an alterative treatment, by giving small doses of calomel, or corrosive sublimate. deed, in that case it will be better to have recourse to warm fomentation of decoction of chamomile, and of sal ammoniac, Wild;- child" i or of salt and water, or of gentle and long-continued friction with the hand, or with stimulating oils. The part should be kept warm; and if the above plan is found too troublesome to be employed, in the absence of ail‘ectionate care, a ararm plaster of cummin-seed may be applied. If we find that there is a concealed scrophulous action in the system, but that where the skin is exposed there chiefly the glands swell, it is most probable that the glands are suf- fering by sympathy with the skin ; which is the reason I recommend the plan of fomentation and friction ; but when the 225 The extract of cicuta with calomel is a favourite remedy. Electricity is used, not as a counter irritation, but directly affect ing the gland ; it rouses its activity. we must be well aware of the mildness of the nature of a gland which we rouse to activity: no doubt, if there be no malignity in a gland, the rousing the vascular action may be productive of a change, and cause its final absorption; as it is sometimes observed, that a gland having been long indolent, swells, be- comes painful, and then disappears. It is a different expectation which makes the surgeon apa ply caustic to a tumour ; he expects, that being of a. mild, indolent nature, with little capacity of action in it, the life of enlargement of a gland has no such origin, we may apply ei- ther cold solution of ammonia muriata, and cerussa acetata on cloths, or the blister, without deviating from the intention of sels brought into activity; but if the power of re-action be When a tumour is excited to virulence by corroding, or previously subdued, then this irritation makes a revulsion from the deep parts, by bringing the blood which would otherwise pass to the deep parts to supply the superficial vessels ; what- stimulating applications, it is doubted whether the latent ma: lignity of the disease be merely roused, or a new action be produced; our most intelligent surgeons seem to think that rm. n. , , .nf~' '1‘} awnp‘u-W 1' r-- ~ .- »~ w diminishing the vascular action. The general explanation of the action of a blister is, that it excites the lymphatics, and consequently assists the absorption and diminution of the tu- mour. I imagine it is to be explained thus: if the blister be applied where there is a tendency to inflammatory action, the stimulus is propagated backward upon the trunk of the ves- the part, (being diseased), may be too weak for the violent" operation of the caustic, so that the whole part may slough out. Such is the common effect of escarotics and caustics to a wart; the life of the excrescence is weaker than that of the natural parts on which it grows, and consequently while the application is too severe for the diseased action, the sound parts remain unhurt. But this is a dangerous practice in regard to scirrhous tumours; instead of destroying the disease, we may only rouse it to activity. r9 ‘ ‘9' *wwpwq‘ygfl , . W ‘m_ Maser . |