-Ulceration is local death of a part. The vitality of any part of the body-as skin, bone, eye, or internal organ-may be so impaired that a part of its tissue dies and comes away, leaving a hole or ulcer.
The causes of ulceration are external injury, inflammation, blood-poisoning, and any cause which weakens the general health. When once tissue is lost in any of these ways, the uninjured tissue around the part sets to work to repair the loss, and if the vitality is not too much impaired it will fill the part with “granulations,” as they are called, which are red, velvety projections of basement tissue, over which the outer skin can spread and form a scar. This is the end aimed at in the treatment of all ulcers. Ulcers are simple-which result from injury and heal without trouble; constitutional, due to some constitutional taint, as scrofula; varicose, due to the defective circulation in a limb which is affected with varicose veins.
General Treatment.-The simple ulcer requires little treatment. The application of simple ointment (as Calendula ointment or Cetacean ointment) until a healthy scab has formed, is all that will be required. If the healing process flags, or the general health is not good, one or the other of the medicines mentioned below may be given. Chronic or constitutional ulcers of whatever kind should be very carefully dealt with. They are often the expression of a defective general state, and if they are healed up rapidly by means of strong ointments it is very likely that something much worse will happen. The general health must be considered first, a wholesome diet and regimen adopted. If the patient indulges in alcoholic drinks, these must be stopped. Milk, eggs, whole-meal bread, green vegetables, fresh meat and fish, are good; sweets, pastry, spices, and all rich foods are bad. The limb (when the ulcer is on a limb) should be supported by a light bandage, the ulcer being covered with a piece of linen on which a simple ointment is spread (Calendula, Catacean ointment, or Resin ointment).
If the ulcer is foul, it may be cleaned by a bread or yeast poultice. The dressing should be changed two or three times a day, according to the amount of discharge. Some cases of indolent ulcer require perfect rest for their healing. For varicose ulcers the use of the rubber bandage is often of very great advantage.
Medicines.-(Two or three times a day.)
-Slightest injuries ulcerate. In persons whose flesh always heals badly.
-Ulcers angry-looking or black with burning pains relieved by warmth. Ulcers on the toes, which begin with blue-black spots, especially if warmth relieves the pains.
Carbo vegetabilis 6.
-Ulcers which burn and smell offensively.
-Ulcers which spread, and are surrounded with pustules or small ulcers, deep red or bluish sores.
-Ulcers on the toes, especially in old people, commencing with a blister as if caused by a burn.
-Ulcers on the toes, beginning, with black spot; when warmth aggravates or produces pain.
Antim crud. 6.
-Ulcers round and old wart or corn.
-Ulcers which bleed easily; ulcers having small subsidiary ulcers around them.