This section is from the book "Materia Medica And Therapeutics Inorganic Substances", by Charles D. F. Phillips. Also available from Amazon: Materia medica and therapeutics.
The gas has been applied in jet to atonic scrofulous ulcers by M. Demarquay, with much advantage.
Gangrene has been attributed by M. Raynaud to deficient oxygenation of tissue, and Langier and other French surgeons have recorded good results from its local treatment by oxygen (Bulletin de Therapeutique, 1863-66). The destruction of tissue has been checked and limited, the swelling subdued, and the neighboring threatened livid tissue restored to its natural color. Dr. Goolden has recorded severe cases of phagedenic ulceration, especially one affecting the throat, which yielded to local application of oxygen, and he has recently written to renew his advocacy of this remedy (Lancet, i., 1866; ii., 1879).
In cases of unhealthy open wounds, and even hospital gangrene, sulphurous acid has sometimes proved more efficacious than carbolic; this was especially seen in hospitals at Metz during the Franco-Prussian war (Medical Times, ii., 1871, p. 358).
Lotions containing peroxide have been used with advantage in soft chancre and in cases of fetid ulcerations of the mouth.
When the skin is broken and there is purulent discharge, as in severe burns or chilblains, or after wounds or injuries, iodoform ointment or lotions of iodine will disinfect the pus, relieve pain, and promote healing. I agree with M. Lailler (Hopital St. Louis), who states that the former preparation acts as a local anaesthetic, and favors cicatrization in a remarkable degree, "it modifies ulcers of every variety," but should not be used while they are acutely inflamed; this stage being passed, the surface should be carefully cleansed and dried, and then either the finely powdered crystals, or a solution in sulphuric ether (1 part to 8 or 10) should be pencilled over and covered with lint; the ether evaporates, leaving a thin film of iodoform (Medical Record, February, 1878). From observations in eczematous cases, Mr. Squire concludes that it is best used during the puriform stage, and ceases to be suitable when the discharge becomes purely serous - he prefers a glycerole (British Medical Journal, i., 1881). Dr. Richardson speaks highly of a solution of iodine -20 gr. in amyl hydride 1 oz. - for painting over suppurating wounds; this also leaves a thin protective film. Or the vapor of iodine may be applied by putting a few grains of the element between a fold of lint, which is placed over the wound and covered with cerate and oiled silk.
In ulceration about the mouth and tonsils, and in the severe form called "cancrum oris," touching with strong iodine solution is often curative.
When an ordinary ulcerated surface is discharging freely, a lotion of moderate strength is usually more suitable than the solid nitrate, because it does not involve confinement of discharge under a limiting membrane (though, indeed, such membrane may be punctured if necessary).
The best use of the solid stick is made in indolent ulcers with pale small granulations, and but slight discharge. The remedy should be lightly applied over the central parts, avoiding the new tissue at the margins, and under this stimulus, and the protection of the film which is formed, healing will be much quickened. The brittle stick nitrate is superior to the prepared points of "lunar caustic," for it is more soluble. Cuthill insists on the importance of stimulating an ulcer rather by dots and lines of silver nitrate than by coating its whole surface, better exit for discharge being thus given (Edinburgh Medical Journal, 1877).
In chronic indolent ulceration the perchloride is a good stimulant; also the carbonate, finely powdered, has been applied in substance to old and excavated ulcers of the leg, and with good bandaging has succeeded well (Lancet, i., 1862). The salicylate of iron is said to make a useful lotion (Edinburgh Medical Journal, 1877).