Acne indurata : its treatment / by Henry W. Stelwagon.

  • Stelwagon, Henry W. (Henry Weightman), 1853-1919.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Acne indurata : its treatment / by Henry W. Stelwagon. Source: Wellcome Collection.

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    same as in the treatment with simple scarification, and in that with scari¬ fications and acid nitrate of mercury. These three methods, if they may be so-called, will generally be found sufficient to remove the lesions of indurated acne. If simple scarifi¬ cations are not adequate, the application of dilute acid nitrate of mercury or of carbolic acid may be superadded. In those cases in which the acne indurations are capped with a small pustular centre, as in all other cases, another operative method is some¬ times employed. It is that in which the curette is employed in place of the scarifying knife. The tops of the lesions are thoroughly scraped out, and the case may go on without any further measure, or it may be neces¬ sary to repeat the operation, although this is seldom required. The acid nitrate of mercury or the carbolic acid may in some instances be applied as in the method by puncture; the scrapings are, however, usually sufficient without anything else superadded. There is much more irritation caused by the scraping than by puncturing, and in cases so treated it is advis¬ able to prescribe a mild soothing ointment. This method, moreover, as may readily be understood, produces during the time of treatment more disfigurement, and patients will not so willingly submit to it on this ac¬ count alone. It is besides much more painful and terrifying than punc¬ turing, although it must be admitted that it is thoroughly effective. Another operative method which may, upon extended trial, commend itself is electrolysis. So far I have only had a few opportunities of try¬ ing this plan, but in these few instances the result was such as to war¬ rant its employment in other cases. The needle, the same as used for the removal of superfluous hair or an ordinary sewing needle of small size, is attached to the negative pole of a galvanic battery, introduced deep into the lesion and the connection made by patient grasping the sponge of positive pole. The current should be continued a fraction of a minute, depending upon the amount of electrolytic action excited. The appear¬ ance of slight frothing at the point of insertion is evidence that the action has been sufficiently long. From five to fifteen cells of a recently charged battery are generally required; ten cells are most generally applicable. A great deal depends upon the amount of action excited, and the number of cells, as also the period of contact, should be gauged accordingly. Unfortunately this operation is painful, even more so than scarifications, although it is not so terrifying. The pain is not so severe, however, as to forbid its employment, and after a few sittings, a degree of tolerance is established. Occasionally patients are seen who are alarmed by the sight of a knife and in whom even a needle causes more or less apprehension. Such per¬ sons positively object to all operative procedures, it matters not how tri¬ fling the operations themselves may be. In these cases other plans of