Issue 10, pp. 753-832, October 1861, SMSJ

1861.] Uierbu Inflammation*ver, or by other moans. It is true that by the prolongedapplication of the nitrate of silver, loss of substance mayaused but this is far less likely;to occur with lunarcaustic than the more powerful escharotics, It is also true,that some practitioners apply the more violent causticslightly that they do not exceed the milder medical action o['the solid nitrate of silver : but in such cases it would bequite as well to use the safer remedy where a caustic is required."And at p. 2(^6, "In applying the nitrate of silver,the aim should he not to produce any slough or loss of sub-Btan< Thus it is clearly stated that the slight applicationof the Btrong caustics is tantamount to the full actionof the nitrate of silver in like cases of uterine disease.My experience, on the contrary, teaches me that nitrateof silver is no more a caustic than tincture of cantharides,a- Mr. Hiffffinbottom PClias lonsr ~ ago o asserted. The distinctionthat Dr. Meigs draws between the antiphlogistictouches and the escharotic action of nitrate of silver, doesnot hear examination. Use it as you may the nitrate ofsilver does not cauterize. Leave it in the neck of thewomb, it will cause more pain, loss of blood and subsequentdischarge, hut no destruction of tissue, unless coagulatedmucus mixed up with epithelial scales and insoluble chloridesof silver can be called such. Even when applied to afungous ulcer, the slight loss of substance is rather due tothe friction of a hard body on a pulpy than to the chemicalcombination of the neutral salt and the diseased tissues, .Vdensely hypertrophied neck of the womb might be whitenedwith the solid nitrate of silver every fourth day untildoomsday, without much reducing its bulk. Indeed I haveseen >\\o}i a plan of treatment injudiciously continued for ayear or longer in a case of hysteralgia, the neck of thewomb 1- althy and of an average size, and the effectswere rather astringent than caustic, condensing the tissues,narrow]' ervical canal, and rendering its dilatationnecessary and difficult Thus, while nitrate of silver mayrepeatedly applied without inducing a loss of Bubstance,the slightest application of the potassa fusa to the neck ofthe womb produces an evident loss of substance ;ami th