NITRATE OF SILVER.
431
mentioned facts before us, as to the curative powers of this salt, theobservation of Georget ( Physiol. du Systeme Nerv. ii. 401), that he hasgreat difficulty in conceiving how the blindest empiricism should haveled any one to attempt the cure of a diseased brain by cauterizing thestomach, is, I conceive, most absurd, and unwarranted. The caseswhich have been relieved by it are probably those termed by Dr. M. Hall(Led. on the Nerv. System, p. 143) eccentric. Tn the few instances inwhich I have seen this remedy tried, it has proved unsuccessful; butit was not continued long, on account of the apprehended discolorationof the skin.
Tn chorea it has been successfully employed by Dr. Powell {Med.Trans, of the College of Phys. iv. 85), Dr. Uwins {Ed. Med. and Surg.Journ. viii. 407), Dr. Crampton {Trans, of the King and Queen's Collegeof Phys. iv. 114), Lombard {Rust’s Magaz. xl.), and others. In anginapectoris it has been administered in the intervals of the paroxysms withoccasional success by Dr. Cappe {Duncan’s Annals of Med. iii.), and byDr. Copland {op. cit.) In chronic affections of the stomach (especiallymorbid sensibility of the gastric and intestinal nerves) it has beenfavourably spoken of by Autcnreith (Dierbacli’s Neust. Entdeck. in d. Mat.Med. 1837, i. 528), Dr. James Johnson {On Indigestion, 2 d ed. p. 87),and llueff (Diebach, op. cit.; also Americ. Journ. of Med. Scien. May1837, p. 225). It has been employed to allay chronic vomiting connectedwith disordered innervation, as well as with disease of the stomach(scirrhus and cancer), and to relieve gastrodynia. The foregoing are themost important of the diseases against which nitrate of silver has beenadministered internally.
As an external agent its uses are far more valuable, while theyare free from the danger of staining the skin. It is employed some-times as a caustic, and as such it has some advantages over potassa fusaand the liquid corrosives. Thus, it does not liquify by its application,and hence its action is confined to the parts with which it is placed incontact. It is used to remove and repress spongy granulations in woundsand ulcers, and to destroy warts, whether venereal or otherwise. It isapplied to chancres on their first appearance, with the view of decom-posing the syphilitic poison, and thereby of stopping its absorption, andpreventing bubo or secondary symptoms. This practice has the sanctionof Mr. Hunter. I have several times seen it fail, perhaps because it wasnot adopted sufficiently early. The nitrate should be scraped to a point,and applied to every part of the ulcer. This mode of treating chancreshas been recently brought forward by llatier {Arch. Gen. de Med. xv. 47,andxvi. 62) as if it were new, and as forming part of Bretonneau’s ectrotic{ectrotica, A-nrpwo-cw, I abort,) method of treating diseases!
The application of nitrate of silver to punctured wounds is oftenattended with most beneficial effects, as Mr. Higginbottom {op. cit.) hasfully proved. It prevents or subdues inflammatory action in a verysurprising manner. It is equally adapted for poisoned as for simplewounds. To promote the healing of ulcers it is a most valuable remedy.In large indolent ulcers, particularly those of a fistulous or callous kind,it acts as a most efficient stimulant. To small ulcers it may be appliedso as to cause an eschar, and when at length this peels off, the sore isfound to be healed. Mr. Higginbottom {op. cit. p. 11,) asserts that “inevery instance in which the eschar remains adherent from the first