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Every particle of the flesh had sloughed off, and the leg began to heal not "by first intention" but by unhealthy granulations like excrescences. As maybe imagined, it was horribly painful, and there was no chloroform. Day after day I was sent for, and stood by, while this terrible thing was going on, wiping the sweat from the face that, though pale as death, never quivered.
It was a brush which could give the texture and the values of the colour a brush dipped in various tints of light and darkness, according as it poured into the marble the light and the shade, and as it translated into polishings and rough hewings and granulations and every variety of cutting, the texture of flesh, of hair, and of drapery; of the blonde hair and flesh of children, the coarse flesh and bristly hair of old men, the draperies of wool, of linen, and of brocade.
It is useless to perforate the adventitious substance, for the orifice will soon close; and, more than once, when I have made a crucial incision, and cut out the unnatural mass that closed the passage, I have found it impossible to keep down the fungous granulations or to prevent total deafness.
The ulcer that forms in relation to callosities on the sole of the foot is treated by paring away all the thickened skin, after softening it with soda fomentations, removing the unhealthy granulations, and applying stimulating dressings. Treatment of Ulcers due to Constitutional Causes.
#Inoculation Tubercle.# The appearances vary with the conditions under which the inoculation takes place. As observed on the fingers of adults, the affection takes the form of an indolent painless swelling, the epidermis being red and glazed, or warty, and irregularly fissured. Sometimes the epidermis gives way, forming an ulcer with flabby granulations.
The pyogenic membrane, like the granulations of a sore, which it resembles in nature, forms pus, not from any inherent disposition to do so, but only because it is subjected to some preternatural stimulation. In an ordinary abscess, whether acute or chronic, before it is opened the stimulus which maintains the suppuration is derived from the presence of pus pent up within the cavity.
#The Healing Sore.# If a portion of skin be excised aseptically, and no attempt made to close the wound, the raw surface left is soon covered over with a layer of coagulated blood and lymph. In the course of a few days this is replaced by the growth of granulations, which are of uniform size, of a pinkish-red colour, and moist with a slight serous exudate containing a few dead leucocytes.
The shapes of the clouds, and their relation to the weather, the different phases of the sea, all the queer collection of weed and mollusk that it cast ashore, the formation and colors of the cliffs, the different shades and granulations in the sands of beach and pine grove; everything gave her active, hungering mind food for thought and speculation.
Should the part become œdematous, either from general causes, such as heart or kidney disease, or from local causes, such as varicose veins, the granulations share in the œdema, and there is an abundant serous discharge.
The base of the ulcer and the thickened edges should then be freely scraped with a sharp spoon, and the resulting raw surface sponged over with undiluted carbolic acid or iodine, after which an antiseptic dressing is applied, and changed daily till healthy granulations appear. The venous return must be facilitated by elevation of the limb and massage.
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