Part 6 (1/2)

In slight cases the lunar caustic may be pa.s.sed over the inflamed part, and in this manner suppuration and the continuance of inflammation is often prevented.

In those cases in which the suppuration is artificial and attended with severe diffused inflammation, the pus should be evacuated and a cold poultice applied for a day or two; for the too early application of the caustic would only add to this kind of inflammation; see p. 11; afterwards the skin may be removed, and if there be excoriations the caustic may be lightly applied.

2. _Of Inflammation of the Finger._

The following case of inflammation of the finger occurred without any a.s.signable cause.

CASE x.x.xI.

A young man, aged 18, came to me with a painful swelling of the middle finger of the right hand; suspecting deep-seated abscess, I made a free incision and evacuated a little pus. I then applied the lunar caustic within the cavity and directed a cold poultice to be applied with lotion.

On the fourth day my patient had returned to his occupation as a dyer.

CASE x.x.xII.

Miss B. aged 23, had a slight scratch on the inside of the index finger, which issued in severe inflammation extending over the back of the hand. I made a free incision in the part first affected, evacuated a little pus, and directed a poultice to be applied.

On the following day, there was less pain but still great swelling at the back of the hand, which, I think, would have been removed had the caustic been used.

I now applied the caustic freely within the orifice.

On the following day there was less swelling and discharge.

Two days afterwards, the caustic was again applied, and in eight days from the first application of the caustic the hand was quite well.

3. _Of Fungous Ulcer of the Navel in Infants._

It sometimes occurs that a little fungous sore exists upon the navel in infants which is difficult of cure in the ordinary way. I had one case which had subsisted for two years, and another, which had continued for two months, and were, during those periods, a source of great trouble and uneasiness to the mothers of the little patients.

These ulcers are easily cured in the following manner.

The fungus is to be completely removed by a pair of scissors, and when the bleeding has quite ceased, the lunar caustic is to be applied, and the part defended by the gold-beater's skin and kept carefully from any moisture.

In one of the cases mentioned above the eschar was accidentally separated twice and required to be renewed; but both cases were cured in the s.p.a.ce of a few days.

4. _Of Inflammation of the Knee._

Servant women, I suspect from much kneeling in scouring stairs, &c.

are subject to a species of inflammation of the knee which is frequently extremely troublesome.

In one case suppuration of the integuments took place in the forepart of the knee, and the patient was obliged to leave her situation and go to her friends at a distance, although every antiphlogistic means was tried for her relief.

In two other cases, after the application of twenty leeches and the administration of an emetic and purgative medicine, I applied the lunar caustic freely over the whole surface of the knee previously moistened with water. In a few hours the cuticle was raised and vesicated; I evacuated a viscid puriform fluid, and I directed the constant application of the cold poultice and lotion.