Licence: Public Domain Mark
Credit: The works of John Hunter / edited by James F. Palmer. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![turn thebaicae with the caustic, or by the application of an opiate plaster an hour or two before the caustic, which will have a very good effect, especially in women and children, who cannot well bear the caustic long enough to produce its proper effects without these alleviations*. A long while generally elapses before we can bring a cut issue to a proper degree of suppuration, as the means which are employed for keeping it open prevent a good suppuration, by keeping up inflammation ; but caustic seems to answer better, by destroying a certain quantity of sub- stance, which separates in the form of an eschar, and leaves an open sore that will generally suppurate freely. In some the eschar is slow in separating ; in others it will be thrown off in about ten days ; but in others it will require three weeks, the separation being always more rapid when the caustic goes fairly into the cellular membrane, which has less life than the cutis. The separation of a dead part from a living is performed by the ab- sorbents, which take into the circulation the edges of the sound parts which adjoin to the dead, and thus the dead part being set at liberty drops off. But in order to effect this, inflammation is first produced, and then ulceration or absorption follows. The separation takes place sooner or later, in proportion to the life of the part; hence the skin, muscles, and parts which are nearest the heart, slough readily ; tendons and bones slowly; and cellular membrane less readily than the skin. Life in a part is in proportion to the number of vessels it has for its simple sup- port, the vessels for other purposes not adding to its powers of life, con- sidered in itself. In new-formed parts, however, the separation is not so slow as in original parts, although they are disposed to slough more readily; but this depends on a different principle, viz. on weakness, which is consistent with what has been already observed. How far the brain is capable of sloughing I cannot determine, but I should imagine that people would never live long enough for this process to take place. In vegetables we find dead parts rot; but they are not separated as the dead parts of animals, because they have no absorbents ; but if they se- parate, they do so by a process of putrefaction. Soft parts, when about to slough, first become darker coloured, and if exposed to the air become dry and hard. The separation always be- gins at the external edge, forming a groove between the living and dead parts; this groove becomes gradually deeper, till at last it is quite * [Nothing is so effectual for alleviating the pain occasioned by potassa fusa as the application of common vinegar, which immediately combines with the alkali to form a neutral salt. It possesses also another advantage, in restraining the operation of the caustic, which in some instances is very apt to spread beyond the assigned limits.]](https://iiif.wellcomecollection.org/image/b21996623_0001_0636.jp2/full/800%2C/0/default.jpg)
