Part 7 (1/2)
CASE x.x.xIV.
Mr. C. aged 51, scalded his leg ten days ago on the instep. He applied ointments and poultices. The surface remained ulcerated to the extent of three inches in length and an inch and a half in breadth, and presented a considerable thick slough in the centre; the inflammation continued to be considerable with some oedema towards the toes. In such a case I should now recommend a cold poultice to be applied for several days; but the present case occurring early in my trials of the caustic, the latter remedy was applied forthwith over both the ulcer and slough.
On the following day I learnt that the pain after the application of the caustic had been considerable for two hours. It then ceased and the eschar became complete; and there was rather less inflammation and swelling. The patient had kept in bed. I prescribed a pill with the hydrarg. submurias, to be followed by an aperient draught.
On the succeeding day my patient went down stairs and disturbed the eschar, and experienced more pain. The inflammation and swelling were still less. I applied the caustic to the parts of the ulcer exposed by the injury done to the eschar.
During the two following days the inflammation subsided entirely; I evacuated a little fluid from beneath the eschar.
On the next day the eschar appeared adherent, except in the centre which was occupied by the slough.
On the succeeding day, I evacuated a little fluid from beneath the slough.
On the next day I removed the slough entirely by means of a pair of scissors. The subjacent ulcer had a healthy granulated appearance. I applied the lunar caustic to it to form an eschar.
From this time it was necessary to evacuate a little fluid from under the eschar for ten successive days. It then became adherent, and in about a fortnight it separated, leaving the ulcer healed.
CASE x.x.xV.
The following case will present a specimen of my trials of the lunar caustic in larger ulcers.
Anthony Knowles, aged 44, was kicked by a horse on the leg, above the inner ankle, two years ago. The part has never healed, but still remains in the state of an open ulcer, attended by some inflammation.
When I first saw this ulcer it was about two inches in diameter and nearly circular, with high edges, a surface of a greenish colour, and without any healthy granulations. I applied the lunar caustic to form an eschar.
The pain from the caustic was severe for several hours. An eschar had formed round the edges, but in the middle part it was quite wanting; the inflammation surrounding the ulcer had abated, and the green hue of its surface had disappeared. I reapplied the caustic in the central part.
On the following day the eschar appeared tolerably complete in the centre but had separated at one part of the circ.u.mference. I again applied the caustic to the defective part.