On the fourth day the swelling was subsiding and there was no pain. The poultice and lotion were continued.—From this time there was no occasion for any remedy, and the little patient speedily recovered.
Case VII.
Mr. Parr, aged 30, of delicate habit, trod upon a needle which pierced the ball of the great toe; a free crucial incision was made but the needle could not be found; a poultice was applied to the wound and over the poultice a cold lotion.
In the course of a week part of the needle came away. He did not rest as he was enjoined to do, and, in consequence, severe inflammation came on, and in two days time, fluctuation was perceived over the joint, opposite to the puncture; a free incision was made, and some pus was evacuated.
On the following day there was a free discharge, but very considerable inflammation had taken place on the side of the ball of the toe; a free incision was made in this part, and a fresh quantity of pus was evacuated.
On the succeeding day, the inflammation was somewhat abated; but on the next day, it had again become exasperated, and the openings made for the evacuation of matter were somewhat closed by the swelling. I now introduced the lunar caustic very freely into these openings, and reapplied a cold poultice and lotion.
On the following day, I found that my patient had slept well for the first time since the developement of inflammation, and had suffered far less, after the smarting pain from the application of the caustic had subsided, than before; the punctured orifices were open, and the skin, which was extremely tense the day before, was become soft and flexible.
From this time, I found nothing necessary but to repeat the application of the caustic about every third day to subdue inflammation and to keep the wounds open, which it always effected. The joint ever afterwards remained stiff, from which we may infer the violence of the inflammation; and when we consider what was the constitution of my patient, we cannot, I think, doubt that the caustic prevented many serious events usually consequent in such cases under the ordinary treatment.
It is highly worthy of remark, that the good effects of the application of the caustic, in this case, were too immediate and distinct to be mistaken.