Ulcers Case Xxi

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

Mrs. Butcher, aged 52, has two ulcers a little above the outer ankle,

one the size of half-a-crown, the other, of a shilling, of four months

duration, which are now in a healing state by the application of

cerate and poultice; the healing process is going on very slowly.

These ulcers were caused by a fall which bruised the part but made no

wound at the time; two small spots, which she compared to the pustules

of small-pox, formed, broke, and gave rise to the ulcers. I applied

the lunar caustic to form eschars.

At this time I had not begun to defend the eschar by the gold-beater's

skin, and in consequence both these eschars were torn by the patient's

stocking having adhered to them, and there was an oozing of fluid from

the centre of each eschar on examination on the following day. I again

applied the lunar caustic.

On the succeeding day, I found that the large eschar had again been

disturbed, the patient having applied a little linen, instead of

leaving it exposed. I reapplied the lunar caustic.

On the next day both eschars were complete, but there was a little

fluid under the centre of each, which required to be evacuated by an

incision. There was little inflammation or pain.

On the following day, my patient expressed herself as astonished at

the rapid amendment. A little fluid was again evacuated from beneath

the centre of the eschar.

On the next day the smaller eschar was quite adherent; under the large

one, there was still a very little fluid.

About the ninth day, both the eschars were perfectly adherent. In two

days afterwards the eschars began to separate round the edges, and in

a few days more, it was necessary to remove the separating portion by

the scissors.--In the course of time the eschar separated completely,

leaving the ulcers healed.

Mrs. Butcher had no pain after the first four days from the

application of the caustic, and in a week was able to attend to her

household affairs.