What methods are commonly employed for the rapid removal or destruction of lupus tissue?
Cauterization, scarification, erasion and excision are variously practised; the particular method depending, in great measure, upon the extent of the disease, the part involved, and other circumstances.
Name the several caustics, and state how they are employed.
Pyrogallic acid, used as an ointment:—
℞ Ac. pyrogallici, ................................. ʒij
Emplast. plumbi, ................................. ʒj
Cerat. resinsæ, .................................. ʒv. M.
It is applied for one or two weeks. Every several days the parts are poulticed, the slough thus removed, and the ointment reapplied, and so on until the diseased tissue has been destroyed. It is useful in those cases in which a mild and comparatively painless caustic is advisable. In most cases several repetitions of this plan are necessary. Arsenious acid, employed as an ointment—
℞ Ac. arseniosi, ................................... gr. xx
Hydrarg. sulphid. rub., .......................... gr. lx
Ungt. aquæ rosæ, ................................. ℥i. M.
It is painful but thorough; it is spread on lint and renewed daily. The action is usually sufficient in three days, and the parts are then poulticed until the slough comes away, after which a simple dressing is employed. Its application is advisable for a small area only—not more than four square inches—as absorption is possible.
Galvano-cautery.—The diseased tissue is destroyed by numerous punctures with a red-heated point or by linear incision with a red-heated knife. It is often a practicable and satisfactory method. The Paquelin cautery and liquid air and carbon dioxide also have their advocates.
Describe the operative measures employed in the removal of lupus tissue.