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Burns Case Xxxvi





Category: OF SOME CASES IN WHICH THE CAUSTIC IS INAPPLICABLE.
Source: 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
size.






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