An Essay on the Application of the Lunar Caustic in the Cure of Certain Wounds and Ulcers — John Shaqi
An Essay on the Application of the Lunar Caustic in the Cure of Certain Wounds and UlcersHigginbottom, John
Science
An Essay on the Application of the Lunar Caustic in the Cure of Certain Wounds and Ulcers
Higginbottom, John
Antiseptics; Silver nitrate; Wound healing
In two days the eschar was separated leaving the ulcer with its
fungous appearance. I removed the fungous part by scissors, and
directed the poultice to be applied and to be continued for two days.
I then formed another eschar. This required a daily puncture for the
evacuation of subjacent fluid, for six days; it then remained
adherent, and in about a fortnight it separated leaving the ulcerated
surface healed. This patient was not at all confined.
CASE XXXI.
Mr. S. aged 30, had a sore two inches in length in the groin, the
remains of a phagedenic ulcer. It had remained stationary a whole
fortnight under the ordinary treatment by bandage. I applied the lunar
caustic to form an eschar and then the gold-beater's skin.
The day afterwards, I found the eschar incomplete and I applied the
caustic again. The eschar was still incomplete on the following day,
and the caustic was again required to be applied to the denuded parts.
On examination two days afterwards I found the eschar complete and
adherent.
On the fourth following day, great part of the eschar had separated
leaving the ulcer healed, and I had no occasion to see the patient
again.
IV. OF SOME ANOMALOUS CASES.
1. _Of Whitlow._
The lunar caustic is very useful in the treatment of this painful
affection. Patients seldom apply to the surgeon before suppuration has
taken place. It is then, I think, the best plan to open the abscess
freely, to apply the caustic well within the cavity, and then to
envelope the part by the cold poultice and lotion. In this manner the
pain and irritation are almost immediately removed, after the smart of
the caustic has subsided. A second application is seldom necessary.
In some cases, however, there is an increase of inflammation in a day
or two, which requires the caustic to be again applied. When the
inflammation has subsided, the loose cuticle may be removed, and the
caustic must be applied to form an eschar.
In slight cases the lunar caustic may be passed 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
assignable cause.
CASE XXXI.
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 XXXII.
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