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Of Punctures Etc

Sources: 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 ca
e 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.