The presence of ulcers indicate a diseased state of the system, being in reality the outlets formed by nature to carry off matter, which, unless removed, might produce serious disturbance of some internal organ. The treatment should be directed to remove the disturbing cause, and where this is done, the ulcer will generally heal of itself.
1. Simple Ulcer. - The simple, purulent, or healthy ulcer, is characterized by pus of thick consistency and white color, readily separating from the surface of the sore. Healthy granulations, small, florid and pointed at the top, speedily follow, and the sore is soon covered by a new skin. But little treatment is necessary, excepting to bathe the parts frequently with tepid water and cover with soft linen lint to absorb the matter
2. Irritable Ulcer. - The surrounding skin is jagged, terminating in a sharp edge. The ulcer generally presents quite a cavity, undermining the skin and discharging a fluid more or less thin and ichorous. The slightest touch may produce pain or cause the ulcer to bleed. The pain may be either constant, slight, or severe, or coming on in paroxysms.
3. The gangrenous or sloughing Ulcer is generally only a stage of the irritable one. In this the edges of the sore have a livid appearance, with small vesicles on them. The surface is dry, and more or less fever is present.
The irritable ulcer should be bathed freely with tepid water. Dry soft linen lint may be placed in the cavity, or the ulcer may be covered with a compress dipped in either cold or warm water, as is most agreeable to the patient.
If the ulcer presents a livid aspect, or bleeds readily, secreting an ichorous fluid, mixed with blood, and espe-ically if there is burning pain, Arsenic may be given in alternation with Carb-v., a dose of one in the morning, and the other at night. Lachesis may be substituted for the Carbo in case the surrounding parts present a mottled appearance.
4. Indolent ulcer. - The irritable ulcer frequently runs into this variety, or may, in some degree be complicated with it Fomentations, such as bread and milk poultice, applied for two or three days, will often so stimulate the ulcer as to cause it to put on a healthy appearance. Sulphur and Silicea may be alternated in the same manner as indicated above, for one week, when, if improvement is not perceptible, Calcarea and Sepia may be substituted. Should an ulcer proceed from a diseased state of the bone, Mercury and Sulphur may be given in the same manner, followed if necessary by Calcarea and Zycopodium.
A very obstinate ulcer not unfrequently forms on the lower limbs, occasioned by swelling of the veins. This is called a varicose ulcer. Sulphur is here a prominent remedy, given as above, or Zycopodium and Lachesis may be alternated.
The limb should also be tightly bandaged from below upward.
Syphilitic ulcers, cancerous difficulties, etc. will be treated in their appropriate place.
A powder, or three globules, taken as directed above.