On the next day both eschars were complete, but there was a little fluid under the centre of each, which required to be evacuated by an incision. There was little inflammation or pain.
On the following day, my patient expressed herself as astonished at the rapid amendment. A little fluid was again evacuated from beneath the centre of the eschar.
On the next day the smaller eschar was quite adherent; under the large one, there was still a very little fluid.
About the ninth day, both the eschars were perfectly adherent. In two days afterwards the eschars began to separate round the edges, and in a few days more, it was necessary to remove the separating portion by the scissors.—In the course of time the eschar separated completely, leaving the ulcers healed.
Mrs. Butcher had no pain after the first four days from the application of the caustic, and in a week was able to attend to her household affairs.
Case XXII.
J. Copeland, blacksmith, aged 38, came to me with many deep ulcerations, from the size of a horse bean to that of a pea, attended with great pain, heat, itching and excoriations of the surrounding skin, obliging him to rest at different times, for several days together. These ulcers came without any apparent cause, have continued for many weeks, and have only been a little benefitted by rest, although he has applied many kinds of ointment, the last consisting of equal parts of mercurial and of the tar ointment. I applied the lunar caustic upon each ulcer, but not over the excoriation, and I enjoined the patient to leave the whole exposed to dry.
On the following day, I was gratified to find that eschars had formed upon every ulcer; upon examination, a little fluid was found to subsist under several of the larger eschars; this I evacuated, and I then applied the lunar caustic to the points from which it had issued to make up the breach of continuity of the eschars over the surface of the ulcers. There was far less inflammation and scarcely any pain, and he has continued his occupation of blacksmith.
On the third day nearly all the eschars were adherent; three, however, had unfortunately been removed by an accident; I renewed them by again applying the caustic.
In four days after the last report, most of the eschars had separated from the smallest ulcers leaving the parts healed.