99. The slighter degrees of burn require merely the application of cold water, or the dipping the part in cold water; all other of the prescribed remedies, lead wash and so on, act only by their coldness. If fever be present the internal use of antiphlogistic remedies and a suitable diet must be combined with the local treatment. If the cuticle have been raised into blisters, they should be opened with a fine lancet, without removing the skin, so that the contained fluid may escape. If they be small, they often, under the use of cold, fall together and dry. If the part be deprived of its cuticle, generally it will not bear the cold application, which irritates, and increases the pain; but simple, mild, soothing remedies, mucilaginous, mild poultices or fomentations, a liniment of pure oil and yolk of egg, fresh butter, and other mild salves may be spread on pieces of soft linen, which should be applied over the burnt part, and often changed, or they should be frequently sprinkled with the remedies, to prevent their drying and sticking, so as to soften and cool by their frequent renewal. Cold is always to be applied to the neighbourhood of the parts deprived of their cuticle. When suppuration is established, and the extreme sensibility of the affected part reduced by the use of mild remedies, astringent and drying applications are to be gradually had recourse to: linseed oil, with lime water, zinc ointment, and so on. Lead ointment is said to produce ugly ill-shapen scars, which, however, I have not observed. If much proud flesh occur, it must be kept down with nitrate of silver. If mortification be produced at the instant of the burning, cold application, or, if the parts are very sensitive on account of the destruction of the cuticle, merely softening and soothing applications must be used till the slough is thrown off by the suppuration, when the remedies aforesaid must be employed. Sloughing rarely extends in this case, if not accompanied by deterioration of the juices. In other respects its treatment, even when resulting from the inflammation depending on the burn, is to be after the same general rules laid down for gangrene.

The remedies especially recommended for burns are very various, and in part completely contrary to each other in their operation. 1. Popular remedies, such as poultices of scraped potato, apples, moist earth, and so on, which are cooling by their proper renewal. 2. Applications of spirituous fluids, æther, alcohol, brandy and so on, if used cold, act also coolingly by quick evaporation; if warm, they can only act as counter irritants but all burns in which the rete cutaneum is exposed must be protected from irritation. 3. The burnt part is brought near to the fire immediately after the burning. 4. Wraps, by which the burnt parts are kept perfectly closed against external influences. The overlaying of fine cotton or wadding, to be kept moderately tight with bandages till it falls off. If blisters are present, they must be first punctured. The strewing with flour and bandaging with dry linen. If pain recur, the linen should be removed and the flouring repeated again and again till it is a quarter or half an inch thick. In very severe burns, after a fortnight, a fourth of calamine powder is added to the flour and applied moist. Covering with chalk, smearing with ambervarnish or tragacanth mucilage spread on blotting paper or fine linen. The watery solution of lunar caustic, recommended by FRICKE, operates in a similar way, by defending the sensitive surface and furnishing it with a covering beneath which speedy healing takes place. In like manner is the operation of kreosote to be explained, from which, when diluted with water, or mixed with grease as a salve, I have frequently observed the best consequences. 5. Various ointments for burns, consisting of fat, butter, wax, cream, and the like. LARREY forbids all cold and cooling remedies, and uses saffron ointment and ointment of styrax. 6. Solution of chlorate of lime, wherewith the bandage is to be frequently moistened during the day, causes a slight itching for about ten minutes, and is, according to LISFRANC, useful in slight degrees of burn, producing new skin in twenty-four hours; in higher degrees the suppuration is diminished and improved.

Much difference of opinion has existed and still exists among English surgeons, as to

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THIS excellent work, published with the unpretending title of “Handbook to the Author's Lectures," has, in passing to the Sixth Edition, gradually increased in extent and importance, and presents a complete view of European Surgery in general, but more especially of British Surgery, which appears to have materially influenced the writings and practice of this able surgeon, and to have led to the production of a SYSTEM OF SURGERY well fitted to supply the "acknowledged want" in this department of the Healing Art under which the Medical Profession have long laboured, no complete system of surgery having appeared in England since BENJAMIN BELL's work, first published in 1783, and now almost obsolete.

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In the Preface to the Fifth Edition, the author observes :pidity with which the fourth edition, consisting of above two thousand copies, has been exhausted, and the translation of the work into SEVEN LANGUAGES, are such honourable and pleasing proofs of the continued satisfactory reception and utility of this hand-book, that I have taken the greatest pains to increase and improve it in correspondence with the progress of Surgery."

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