om all other forms of ulcers,
and call for totally different treatment, it is best to consider them
along with the tumours with which they are associated. Rodent ulcer,
which is one form of cancer of the skin, will be discussed with new
growths of the skin.

B. #Arrangement of Ulcers according to their Condition.#--Having arrived
at an opinion as to the cause of a given ulcer, and placed it in one or
other of the preceding groups, the next question to ask is, In what
condition do I find this ulcer at the present moment?

Any ulcer is in one of three states--healing, stationary, or spreading;
although it is not uncommon to find healing going on at one part while
the destructive process is extending at another.

_The Healing Condition._--The process of healing in an ulcer has already
been studied, and we have learned that it takes place by the formation
of granulation tissue, which becomes converted into connective tissue,
and is covered over by epithelium growing in from the edges.

Those ulcers which are _stationary_--that is, neither healing nor
spreading--may be in one of several conditions.

_The Weak Condition._--Any ulcer may get into a weak state from
receiving a blood supply which is defective either in quantity or in
quality. The granulations are small and smooth, and of a pale yellow or
grey colour, the discharge is small in amount, and consists of thin
serum and a few pus cells, and as this dries on the edges it forms scabs
which interfere with the growth of epithelium.

Should the part become oedematous, either from general causes, such as
heart or kidney disease, or from local causes, such as varicose veins,
the granulations share in the oedema, and there is an abundant serous
discharge.

The excessive use of moist dressings leads to a third variety of weak
ulcer--namely, one in which the granulations become large, soft, pale,
and flabby, projecting beyond the level of the skin and overlapping the
edges, which become pale and sodden. The term "proud flesh" is popularly
applied to such redundant granulations.

[Illustration: FIG. 18.--Callous Ulcer, showing thickened edges and
indurated swelling of surrounding parts.]

_The Callous Condition._--This condition is usually met with in ulcers
on the lower third of the leg, and is often associated with the presence
of varicose veins. It is chiefly met with in hospital practice. The want
of healing is mainly due to impeded venous return and to oedema and