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.

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    covered with sweet oil. The removal of other forms of hemorrhoidal tumors can be effected best by means of the ligature or clamp. Nitric acid is a useful application in the treatment of Prolapse of THE Rectum, and is recommended for this purpose by Cripps, Agnew, Kelsey, and Allingham. It is, however, of little service except in the case of children. The action of nitric acid on the prolapsed rectum can be well understood if we recall the way in which prolapse generally begins. The mucous coat is attached to the muscular coat by loose, con- nective tissue, so that there is considerable mobility of the one coat upon the other. Partial prolapse is the result of the gradual stretching of the submucous tissue. In complete prolapse, after the mucous coat has slid as far as possible, it drags upon the muscular coat and produces eversion of the bowel. The action of the nitric acid is to create inflam- mation with resulting exudate into the loose connective tissue, and the formation of new contractile, fibrous material, which binds the two coats firmly together. The application of nitric acid for prolapse of the rectum is made by first carefully cleaning the bowel and then applying fuming nitric acid freely over the mucous membrane, care being taken to avoid the skin. The bowel should then be greased and returned, and a pad placed over the anus. Nitric acid is recommended by Thomas as an efficient caustic in cases of Cancer of the Cervix Uteri, which are not subjected to surgical opera- tion. The acid is applied thoroughly to the whole diseased surface, and a pad of cotton saturated with glycerin is placed over it. This applica- tion produces a decided slough and destroys many of the blood-vessels which have proved the sources of hemorrhage. Thomas states that such an application should be repeated once in every two or three months. Nitric acid has been emplo3^ed by Atthill, Goodell, and others with advantage in cases of Fungoid Granulation and Excessive Hemor- rhage OF the Uterus. It is introduced by means of cotton on the applicator. In Cancer of the Uterus, West speaks highly of a lotion of nitric acid, a drachm to the pint of water, to check profuse discharge. Diseases of the Skin.—The strong nitric acid of the Pharmacopoeia is used as a caustic in some diseases of the skin. It deoxidizes the tissues, depriving them also of water and leaving a dry, charred eschar. It is employed in the destruction of Epithelioma, Verucca, NJevi, and other new growths. The acid is best applied by means of a pointed splinter of wood, the excess being carefully wiped off with cotton. In destroying warts care must be taken not to allow the action to go too far, or a slough with consequent cicatrix may result. Likewise hemorrhage may follow on the separation of the slough when UEevi have been destroyed by