A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    127/878 (page 103)
    ULCERATION. ]03 rences that the disposition to contract seemed to cease. But more will be said on these matters in another part of the work. With regard to attitude, it may be deemed an established rule, that the affected part should always, if possible, be kept on a level with, or above, the rest of the body. If this be not attended to, the healing process goes on much more slowly, (if it goes on at all,) and hence, then, the advantage of keeping a person in the horizontal position, who has a sore on the leg. These rules of practice will be more fully illus- trated in describing the treatment of injuries and ulcers of the lower extremities, as well as of other parts of the body. I may state, how- ever, that there is a combination of benefit in rest, position, or attitude, and support by straps, rollers, or other convenient apparatus, which is not always taken into due account. For instance, if a person with a healthy sore on the leg, who has been kept to his bed, is allowed to get up and walk about, the sore is almost certain to retrograde, unless some support be given to the tender vessels in the equally tender gra- nulations : they will burst and bleed on the surface, or effusion and infiltration of serum in the organized lymph will speedily occur, when days or weeks may elapse ere the part resumes the condition in which it was when the patient was first allowed to get out of bed. The process of ulceration, which is usually deemed a product or con- sequence of inflammation, is always a source of much vexation to the surgeon, often of great annoyance to the patient, and not unfrequently of the utmost danger. It is one over which the practitioner has but little control; it usually causes much pain and alarm, and occasionally opens important organs, as the stomach, intestines, or large blood-ves- sels, so as to cause speedy death. The terms ulcer and ulceration seem often to be confounded with each other, although in the proper application and acceptation of these words, there is really a great difference. Ulcer is a generic term ap- plied to all sorts of sores, more particularly to those which are on sur- faces, but in many such, ulceration has never at any time been present. A person who has sores on his legs within a few days of healing over, is said to have ulcers, and the term is perfectly understood in some respects, although the difference between these surfaces at the commencement of the disease, and towards the end, is not always sufficiently appreciated. In the early stages nature seems determined that the affection shall spread, whatever opposition the surgeon may offer: parts visible to the eye at first, in a few days disappear by the ulcerative process: the sores go on increasing in size so long as the CHAPTER XIII. ULCERATION.