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
On the following day the eschar was observed to be adherent, and the
patient reported that she had suffered scarcely any pain, after the
smarting of the caustic had ceased. There was a slight swelling round
the puncture but that of the arm had totally subsided. The caustic was
applied over and beyond the swelling. On the third day all tumefaction
had subsided and there was no complaint whatever.
I hoped that this case would have required no further attention or
remedy. But my patient contrived unfortunately to rub off the eschar
about a week after its formation, and so to expose the subjacent wound
unhealed; she suffered however no pain or inconvenience from it; and
it was again shielded by means of a fresh eschar, which remained
adherent until removed by the healing process underneath.
This puncture was so severe that the arm was in a state of ecchymosis
for six or eight inches upwards, and I doubt not that without the
caustic, there would have been severe and long continued suffering,
and perhaps painful suppurations.
CASE III.
A female servant punctured the end of the finger by a pin; there
succeeded much pain and swelling, and it appeared that the nail would
separate, and the cuticle all round the finger was raised by the
effusion of fluid. This fluid was evacuated and a poultice applied.
On the third day the cuticle was removed, and the exposed surface was
found to be ulcerated in several spots. The lunar caustic was passed
slightly over the excoriated surface, which was then left exposed to
dry.
On the succeeding day the eschar was adherent and the pain had almost
subsided. On the next day, the eschar still remained adherent, and as
there was neither pain nor soreness, the patient used her finger.
The eschar was at length removed by the healing process and was
separated together with the nail, and the case was unattended by any
further inconvenience or trouble either to the patient or myself.
It is scarcely necessary to contrast the advantage of this mode of
treatment with that by plasters, poultices, &c. It is at once more
speedy and secure, and less cumbersome to such patients as are obliged
to continue domestic avocations.
CASE IV.
The present case is somewhat more severe than those which have been
already given, and what is of great importance, the caustic was not
applied immediately after the accident.
William Chantry, aged 50, received a stab in the wrist with a hay-fork
yesterday and applied a poultice; to-day there are great pain and
swelling, and the wounded orifice is very small. I applied the lunar
caustic within the puncture, and directly a cold poultice to be worn
over it; the arm was kept in a sling.
The next day the swelling and pain were diminished, and a little lymph
flowed from the wound. I again applied the caustic and continued the
poultice.
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