resulting raw surface sponged over with undiluted carbolic acid or iodine, after which an antiseptic dressing is applied, and changed daily till healthy granulations appear. (2) The venous return must be facilitated by elevation of the limb and massage. (3) The induration of the surrounding parts must be got rid of before contraction of the sore is possible.  For this purpose the free application of blisters, as first recommended by Syme, leaves little to be desired.  Liquor epispasticus painted over the parts, or a large fly-blister (emplastrum cantharidis) applied all round the ulcer, speedily disperses the inflammatory products which cause the induration.  The use of elastic pressure or of strapping, of hot-air baths, or the making of multiple incisions in the skin around the ulcer, fulfils the same object.

As soon as the ulcer assumes the characters of a healing sore, it should be covered with skin-grafts, which furnish a much better cicatrix than that which forms when the ulcer is allowed to heal without such aid.

A more radical method of treatment consists in excising the whole ulcer, including its edges and about a quarter of an inch of the surrounding tissue, as well as the underlying fibrous tissue, and grafting the raw surface.

Ambulatory Treatment.—­When the circumstances of the patient forbid his lying up in bed, the healing of the ulcer is much delayed.  He should be instructed to take every possible opportunity of placing the limb in an elevated position, and must constantly wear a firm bandage of elastic webbing.  This webbing is porous and admits of evaporation of the skin and wound secretions—­an advantage it has over Martin’s rubber bandage.  The bandage should extend from the toes to well above the knee, and should always be applied while the patient is in the recumbent position with the leg elevated, preferably before getting out of bed in the morning.  Additional support is given to the veins if the bandage is applied as a figure of eight.

We have found the following method satisfactory in out-patient practice.  The patient lying on a couch, the limb is raised about eighteen inches and kept in this position for five minutes—­till the excess of blood has left it.  With the limb still raised, the ulcer with the surrounding skin is covered with a layer, about half an inch thick, of finely powdered boracic acid, and the leg, from foot to knee, excluding the sole, is enveloped in a thick layer of wood-wool wadding.  This is held in position by ordinary cotton bandages, painted over with liquid starch; while the starch is drying the limb is kept elevated.  With this appliance the patient may continue to work, and the dressing does not require to be changed oftener than once in three or four weeks (W.  G. Richardson).

When an ulcer becomes acutely inflamed as a result of superadded infection, antiseptic measures are employed to overcome the infection, and ichthyol or other soothing applications may be used to allay the pain.