e
smeared with a 6 to 8 per cent. ointment of scarlet-red, the surrounding
parts being protected from the irritant action of the scarlet-red by a
layer of vaseline. A dressing of gauze moistened with eusol or of
boracic lint wrung out of red lotion (2 grains of sulphate of zinc, and
10 minims of compound tincture of lavender, to an ounce of water), and
covered with a layer of gutta-percha tissue, is also useful.

When the condition has resulted from the prolonged use of moist
dressings, these must be stopped, the redundant granulations clipped
away with scissors, the surface rubbed with silver nitrate or sulphate
of copper (blue-stone), and dry dressings applied.

When the ulcer has assumed the characters of a healing sore, skin-grafts
may be applied to hasten cicatrisation.

_Ulcers in a callous condition_ call for treatment in three
directions--(1) The infective element must be eliminated. When the ulcer
is foul, relays of charcoal poultices (three parts of linseed meal to
one of charcoal), maintained for thirty-six to forty-eight hours, are
useful as a preliminary step. The base of the ulcer and the thickened
edges should then be freely scraped with a sharp spoon, and the
resulting raw surface sponged over with undiluted carbolic acid or
iodine, after which an antiseptic dressing is applied, and changed daily
till healthy granulations appear. (2) The venous return must be
facilitated by elevation of the limb and massage. (3) The induration of
the surrounding parts must be got rid of before contraction of the sore
is possible. For this purpose the free application of blisters, as first
recommended by Syme, leaves little to be desired. Liquor epispasticus
painted over the parts, or a large fly-blister (emplastrum cantharidis)
applied all round the ulcer, speedily disperses the inflammatory
products which cause the induration. The use of elastic pressure or of
strapping, of hot-air baths, or the making of multiple incisions in the
skin around the ulcer, fulfils the same object.

As soon as the ulcer assumes the characters of a healing sore, it should
be covered with skin-grafts, which furnish a much better cicatrix than
that which forms when the ulcer is allowed to heal without such aid.

A more radical method of treatment consists in excising the whole
ulcer, including its edges and about a quarter of an inch of the
surrounding tissue, as well as the underlying fibrous tissue, and
grafting the raw surface.

_Amb