Twelfth.--The pain and constitutional symptoms occasioned by the disease, considered as distinct from the symptoms which may be dependent on disease endemic in the country, are all relieved, and sometimes entirely removed, by the destruction of the diseased surface, which must, however, be carefully and accurately followed, to whatever distance and into whatever parts it may extend, if the salutary effect of the remedies is to be obtained.
Thirteenth.--On the separation of the sloughs, the ulcerated surfaces are to be treated according to the ordinary principles of surgery. They cease to eliminate the contagious principle, and do not require a specific treatment.
Fourteenth.--The constitutional or febrile symptoms, whenever or at whatever time they occur, are to be treated according to the nature of the fever they are supposed to represent, and especially by emetics, purgatives, and the early abstraction of blood if the fever be purely inflammatory, and by less vigorous means if the fever prevailing in the country be of a different character. Pain should be alleviated by opium, which should be freely administered.
Fifteenth.--The essential preventive measures are separation, cleanliness, and exposure to the open air,--the first steps toward that cure which cauterization will afterward in general accomplish.
Sixteenth.--If the sufferer be very young, or of a weakly habit, his strength will frequently require to be supported in the most efficient manner by a due administration of cinchona bark, wine, and a generous diet,--means often found essentially necessary after all severe attacks of debilitating diseases.
The formidable nature of this terrible disease, before the local application of caustic remedies was fully adopted, will be best understood by the following document.
RETURN _of the_ NUMBER OF CASES _of_ HOSPITAL GANGRENE _which have appeared at the Hospital Stations in the Peninsula between 21st June and 24th December, 1813_.
+---------+---------+-------+-----+----------+--------+------------+ | |No. |Dis- |Died.|Under |No. | | |STATIONS.|of cases |charged| |treatment.|operated|REMARKS. | | |occurred.|cured. | | |upon. | | +---------+---------+-------+-----+----------+--------+------------+ |Santander| 160 | 72 | 85 | 53 | 25 |Most of | |Bilbao | 972 | 557 | 387 | 28 | 183 |these cases | | | | | | | |were sent | | | | | | | |from | | | | | | | |Vittoria. | | | | | | | | | | | | | | | | | |Vittoria | 441 | 349 | 88 | 4 | 74 | | |Passages | 41 | 2 | 2 | | |Thirty-seven| | | | | | | |transferred | | | | | | | |to | | | | | | | |Santander. | | | | | | | | | | | | | | | | | |Vera | | | | | |Vera, being | | | | | | | |almost on | | | | | | | |the field of| | | | | | | |battle, had | | | | | | | |no case. | | | | | | | | | | | | | | | | | | | | | | | | | | +---------+-------+-----+----------+--------+ | | | 1614 | 980 | 512 | 85 | 282 | | +---------+---------+-------+-----+----------+--------+------------+