Ulcers Case Xxix

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

The peculiarity of the present case arose from neglect in evacuating

the fluid effused under the eschar the day succeeding its formation,

the consequence of which was that the edges of the eschar became

raised all round, without however being entirely detached.

Mr. Draper, aged 50, had a small irritable ulcer of the size of a

horse-bean, upon the shin, of a month's duration, with surrounding

inflammation to the extent of several inches. I applied the lunar

caustic to form an eschar and protected it with gold-beater's skin.

On the following day, it appeared from the flatness of the surface,

that the eschar was adherent; the inflammation remained as before.

On the next day the eschar was raised all round its borders,

presenting the appearance of an elevated ring. I made an opening in

one point of this ring by a penknife and evacuated the fluid, and I

again applied the caustic all round in order to give firmness to the

edges of the eschar.

On the succeeding day an opening was made in the centre of the eschar

and a little more fluid was evacuated.

This mode of treatment was continued daily for about a week, the

inflammation gradually subsiding and the eschar becoming adherent and

corrugated. In about three weeks, the patient thinking the sore quite

well detached the eschar; there was still, however, a minute ulcer

left, which was touched with the caustic.