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Of Punctures Etc

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

In cases of recent punctured wounds the orifice and surrounding skin
should be moistened with a drop of water; the caustic should then be
applied within the puncture until a little pain be felt, and then over
the surrounding skin, and the eschar must be allowed to dry. In this
manner it is astonishing how completely the terrible effects of a
punctured wound are prevented; the eschar usually remains adherent,
and the case requires no further attention.

At a later period after the accident, when the caustic has been
neglected, some degree of inflammation is usually present, the orifice
is nearly closed with the swelling, and a little pus or fluid is
formed within. A slight pressure will evacuate this fluid, the caustic
may then be applied within the puncture, and over the surrounding
skin, beyond the inflammation, and must be allowed to dry. In this
manner we frequently succeed in forming an adherent eschar, and all
inflammation subsides. Any slight vesication which may be raised
around punctured wounds is not of the same consequence as when an
adherent eschar is wished to be formed over a sore or ulcer; one or
more small punctures may be made to evacuate the fluid and the part
may be allowed to dry.

If there is reason to think that an abscess has actually formed under
the puncture to any extent, it must be opened freely by a lancet and
treated with caustic and poultice, keeping the poultice moist and cold
with water.

In cases of puncture where the orifice is healed and where an
erysipelatous inflammation is spreading, attended with swelling, I
have applied the caustic freely over and beyond the inflamed parts,
and I have had the satisfaction to find that the inflammation has been
arrested in its progress and has shortly subsided.

This mode of treatment is particularly useful in cases of punctured
and lacerated wounds from various instruments, such as needles, nails,
hooks, bayonets, saws, &c. and in the bites of animals, leech-bites,
stings of insects, &c. In considerable lacerations the same objection
would exist to this treatment as in large ulcers.

The dreadful effects of punctures from needles, scratches from bone,
or other injuries received in dissection, are totally prevented by
this treatment. I have for the last five years had frequent
opportunities of trying it in these cases and have the most perfect
confidence in its success.

The advantage of these modes of treating punctured wounds will however
be best explained and established by a selection of cases, to which I
can add particular remarks as they may be suggested by peculiarities
in the cases themselves.

Next: Punctures Case I

Previous: On The Treatment By Eschar And Poultice

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