A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

    61/554 (page 49)
    nitric acid fumes were used at one time as a disinfectant, but they have long since been superseded by more active and reliable agents. Nitric acid is more extensively used as an escharotic than any other of the mineral acids, its action being easily controlled. It is best applied with a small glass rod or splinter of wood (which may be wrapped with cotton if a more liberal use of the drug is desired), or—what will be found convenient—with a twig taken from a broom. Its caustic action is easily stopped by covering the cauterized surface with sweet oil. In Hospital Gangrene and Phagedenic Ulceration, nitric acid has long been held in high repute. In treatment of hospital gangrene it is important that the sloughs should be thoroughly broken up (as by intro- ducing the blades of a pair of dressing forceps, closed and then opening them), so that the acid may find its way through the sloughing mass down to healthy tissue. By this method much prompter and better results will be obtained than if the acid is applied only to the surfaces of the sloughs. Nitric acid has long been employed, as first recommended by Well- bank, in the treatment of Phagedenic Ulceration, especially of a venereal character. In this method of treatment it is important that the ulcerated surface be thoroughly cleansed and dried, and the surrounding parts protected by a thick coating of cosmoline or oil, to prevent the acid from coming in contact with them, after which a small swab of cotton, fastened to a splinter of wood, is saturated with the acid and carefully pressed into every portion of the ulcer. After permitting it to remain upon the tissues for half a minute, during which time the pain is severe, its action may be quickly stopped by applying a pledget of cotton saturated with sweet oil. After this a cold water dressing may be applied. In the removal of Venereal Warts, we are in the habit of quickly snipping them off with a pair of scissors, and then touching their bases with a drop of nitric acid. This mode of treatment is prompt, efficient, and not very painful. In Chronic Cystitis, especially when the urine is very ammoniacal, the injection of one or two drops of nitric acid, diluted with an ounce of water, very slowly thrown into the bladder, was first proposed by Benja- min Brodie, and is still commended by Sir Henry Thompson. After the bladder has been washed out twice the nitric acid and water (a slightly acidulated solution, containing a small portion of morphine) should be injected and retained as long as possible. Should hemor- rhage occur, tannic acid may be substituted for the nitric acid. Nitric acid is sometimes employed for the removal of Hemorrhoids ; but is suitable only for the small strawberry piles containing a number of vascular twigs which bleed freely on the slightest irritation. Such piles may be exposed with the speculum, touched with acid, and then 4