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Burns Case Xxxiv

Source: Application Of The Lunar Caustic In The Cure Of Certain Wounds And Ulcers

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

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.

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