This case illustrates the mode of treatment by the lunar caustic, of those terrible effects of punctured wounds which have been neglected in the beginning.
B. Unwin, aged 40, washerwoman, applied to me on July the 10th, 1820, with severe inflammation and ulceration of the middle finger, arising from a puncture by a pin or needle some time before; there was much painful tumefaction, and the integuments had burst along nearly half of the length of the finger, on the ulnar side, and over the middle joint on the radial side; the probe did not however pass to the bone or into the joint. I applied the lunar caustic deep in every part, and over the whole surface, and enveloped the finger in a cold poultice covered with cold water.
On the 11th she reported that she had slept well for the first time during the last fortnight; to-day there is scarcely any pain, but she complains of soreness; the swelling has greatly subsided. The caustic was again applied and the poultice and lotion continued.
On the 12th there were still swelling and pain; there was considerable bleeding from the wound, so that I could not apply the caustic well.
On the 13th the swelling and pain were nearly gone. I repeated the caustic which induced bleeding from the fungous flesh.
On the 14th the swelling had nearly subsided; the cuticle was separating all over the finger. The lunar caustic was applied extensively over the wound and abraded parts and induced little bleeding or pain.
On the 15th the fungous was nearly removed; the wound presented an appearance of slough over its surface.—The caustic was applied to the remaining fungous.
On the 17th the wound was much smaller and the slough separating. The caustic and cataplasm were applied as before.—A similar report was made on the succeeding day.
On the 20th the slough was separating. The caustic and cataplasm were applied.—A similar report was made on the 22d.
On the 24th the slough having separated the integuments over it were flabby and loose; the caustic was applied to them.