Mr. Erasmus "Wilson, are effectually cured by laying them open with a lancet or bistoury, pressing out their contents, and injecting the cyst with a solution of the Nitrate of Silver, or touching its internal surface with the solid caustic. He much prefers this plan to the painful process of excision.
354. In Scrofulous enlargements of Glands, &c., Mr. Balman considers that much mischief is done by the indiscriminate use of Iodine frictions, and prefers, in the absence of all inflammatory action, pencilling the part with the solid Nitrate a few times, at intervals of a week or ten days. He thinks it milder and safer than the use of blisters, the action of which is more diffusive and irritating.
Brown§ (U.S.) advises the application of a solution of Nitrate of Silver (3J. - Aq. fj.) to the fauces, whether ulceration be present or not. It is to be used once or twice daily. He states that previous to adopting this treatment he lost half his cases, but subsequently, during the same epidemic, he lost only 1 in 50.
Graves|| advises the local application of a solution of Argent Nit. (gr. x. - xv. - xx. to Aq. fj.). He directs it to be strongly rubbed into each spot, for which purpose a small piece of sponge, covered with fine linen, and tied to the end of a slender stick, should be employed. When a large portion of the scalp is affected, it requires some perseverance to apply the solution effectually. The hair should be cut short, not shaved; the scales should then be removed by diligent ablution. The solution should be applied, and repeated, not oftener than once a week. The scalp should then be covered with a dressing of Ungent. Cetacei, which is to be renewed four times daily, so as tokeep the head constantly moistened with it. Three days after the first application of the caustic, the head may be washed with yellow soap and water twice a day, and the ointment replaced after each dressing. In this, as in other cutaneous affections of long standing, it should always he a matter for consideration how far it is safe suddenly to check it. Before attempting a cure, an issue or seton may, if deemed necessary, be established at a distant point.
* Edin. Med. Surg. Journ. vol. xxxv. Op. cit. p. 409. Med. Gaz. Aug. 22, 1851.
§ Philadelphia Med. Exam. Feb. 1850 (E).
|| Dublin Journ. vol. xviii. p. 241, and Clin. Lectures, vol. ii. p. 352. 1848.
357. In Porrigo, Psoriasis, Impetigo, and other Cutaneous Diseases which have resisted milder remedies, the solid Nitrate, locally applied, has been found effectual. It should not be applied extensively at once, but small portions should be successively cauterized at intervals of a few days. In Porrigo, Dr. Pereira says that he has never known the practice to fail, or to cause the loss of hair, although in one case, a child, fever and delirium were produced by its excessive use. In Impetigo, an acpaeous solution is sufficient.