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Medical ArticlesLimbs Drawn-upWe have had many cases of contracted limbs, arising from vario... The Surgical Dissection Of The Sterno-clavicular Or Tracheal Region And The Relative Position Of Its Main Bloodvessels Nerves &c The law of symmetry governs the development of all structures... Ipecac acts very beneficially when applied to the surface where ther... Throat Hoarseness This is best treated by a good large BRAN POULTICE (see) on th... Breath And The Skin The organs of breathing remove much waste from the system, but... Constipation This trouble is often only aggravated and made chronic by the ... Moods RELIEF from the mastery of an evil mood is like fresh air aft... Polypus See Nostrils. ... Symptomatology And Treatment Of Chronic Valvular Lesions Before discussing the treatment of broken compensation in gen... Fruits And Vegetables The Special Uses of Fruits and Vegetables. We come now to t... Water-treatment As Used By Currie Reuss Hesse Schoenlein &c Beside the above modes of treatment _cold_ and _tepid Water_ ... List Of Instruments The following list has been compiled as a convenient basis f... Pulmonary Phthisis Consumption After tubercles have been formed extensively in the lungs, an... Unfavorable Symptoms are: A fetid breath, with ulceration and sloughing of the thr... Tricuspid Stenosis Tricuspid Obstruction This is rare and probably always congenital, and is supposed ... Rheumatism Chronic Use the A D current always in rheumatic affections. If there ... Irritable Bowels Some peoples' lives don't run smoothly. Jeanne's certainly di... Eyes Paralysis Of The partial paralysis of the muscles of one eye produces doubl... Complications Following Esophagoscopy These are to be avoided in large measure by the exercise of ... The Future Of Life Extension I beg the readers indulgence for a bit of futurology about wh... |
Ulcers Case XxviiiCategory: ON THE APPLICATION OF THESE MODES OF TREATMENT TO PARTICULAR CASES. Source: Application Of The Lunar Caustic In The Cure Of Certain Wounds And Ulcers Mrs. U. aged 60, has been subject to ulcerated legs for several years. She has one ulcer on the outer ankle of the size of a shilling, and another behind it of the size of a horse-bean; they have been extremely troublesome and under surgical treatment for the last year, but during the last few weeks she has tried cerate, poultice, and the cold lotion. The leg is much swollen and inflamed, the redness extending several inches round the wound and over the instep; the oedema increases towards night. She has been in the habit of taking saline purgatives frequently. I directed my patient to continue the cold poultice and lotion, and to rest completely for several days. At this period, the inflammation having somewhat abated, I applied the lunar caustic to form eschars and protected the parts with gold-beater's skin. On the following day there was a slight increase of redness round the eschars. Upon making an incision into their centre some fluid was evacuated. The same report was made on each of the two following days. On the seventh day, the eschars having been neglected, fluid had escaped from beneath the eschars at their edges, and my patient complained of more pain. A little more fluid escaped in the same manner on the following day on making a little pressure upon the eschars. I applied the caustic to make up the breach. Subsequently to this day there was an increase of inflammation. From this circumstance, and from the neglect of the eschars for two or three days already mentioned, I suspected the formation of a scab under them. It was impossible to pierce the eschars by the penknife without breaking them, as they had become too hard and thick by delay and the addition of the scab. I again directed the cold poultice for four or five days. On examining the wounds on the separation of the eschars, I found the healing process going on. I reapplied the lunar caustic to form eschars, and I evacuated a little fluid from their centre for three successive days. At this time the patient took cold and a smart attack of fever came on, and the part round the eschars became much inflamed. I prescribed an emetic and purge, and a cold poultice and lotion. In the space of a week I again attempted to form an eschar over the larger wound, for the smaller one had quite healed. The next day I discharged a little fluid from the centre, and again on the eight or nine succeeding days, giving saline purgatives. After this time the eschar remained adherent, and no further remedy was required. This case is particularly interesting and important, as it illustrates the plans to be adopted in two circumstances of no unfrequent occurrence; 1. when there is an attack of fever and increased inflammation, and 2. when a scab forms underneath the eschar. In both cases we must relinquish our attempt to form an adherent eschar for a time,--apply the poultice,--and recur to the caustic in the course of a few days. In the beginning of my trials of the treatment of the ulcers by the caustic, I was repeatedly betrayed by the smooth appearance of the eschar, to think that all was going on well, when in fact a scab was all along forming underneath. In these cases inflammation soon followed, and it was only by carefully and daily evacuating the fluid effused under the eschar that I at length succeeded in effecting an adherent eschar free from surrounding inflammation. This remark cannot be too often repeated. Next: Ulcers Case Xxix Previous: Ulcers Case Xxvii
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