Burns Case Xxxvi

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

The last case I have to give is one of great interest, as it clearly

shows the influence of the lunar caustic in subduing the inflammation

surrounding ulcerations, and in promoting the healing process, even in

cases of phagedenic ulcer. In such cases its influence eminently

deserves a still further trial.

Mrs. H. aged 56, has had very extensive phagedenic ulcerations on the

legs and thighs during three years, which began in little red spots

and then spread rapidly, destroying the integuments. One of these

ulcers, on the thigh, was twelve inches in length and five in breadth,

and exhibited the appearance of a deep corroding furrow; it was

surrounded by a fiery redness and was attended by extreme pain. There

were many other ulcers of the same kind, several nearly of the same

magnitude; and the poor patient was compelled to take large doses of

laudanum several times in the day. She had formerly been treated for

syphilis, and had afterwards taken the sarsaparilla freely; amongst a

great variety of local applications, the white bread poultice had

afforded most relief.

I applied the lunar caustic to two of the smaller ulcers.

On the following day the eschars were complete. I applied the caustic

to the large sore above described to the extent of three inches

square, avoiding its application on the inflamed skin.

On the next day I found the eschar last made complete, and I passed

the caustic over the ulcer to the extent of three inches more.

On the succeeding day, the eschar was complete, adherent at those

edges which adjoined the cuticle, and floating at the other edges over

the ulcer, and in the latter part allowing the escape of matter; round

the adherent edges of the eschar the inflammation had entirely

disappeared, while it remained fiery as before round every other part

of the ulcer.

I continued my trials with the caustic in this case, but it gave so

much pain, and I had so little hope of final success, that I

altogether relinquished the attempt to treat these ulcers by eschar.

Some of the small ulcers were healed, however, and the larger one

assumed a more healthy character wherever the caustic had been

applied. It may, therefore, remain a question whether the lunar

caustic may not still prove useful in phagedenic ulcers of a smaller