The same patient has since been affected by similar ulcers at different times in different parts of the leg. He applied early and they were each time easily cured by one application of the caustic. He has also twice had injuries upon the shin, which were readily cured in the same manner.
Case XXIV.
The following case must not be regarded as altogether trifling. For such sores are very apt to spread and to remain long very troublesome.
An old gentleman came to me with an oblong ulcer on the shin about an inch in length; it was very painful and inflamed. I applied the lunar caustic to form an eschar and requested him to call on the following morning. He did not come, however, but on seeing him the next day it was requisite to evacuate a little fluid; this was repeated on they third day, after which period the eschar remained adherent, and the part totally free from pain.
The eschar separated in about three weeks leaving the part healed.
Case XXV.
The following case illustrates the superior efficacy of the lunar caustic over the ordinary modes of treatment in some ulcers of the legs, and will, I trust, be found particularly interesting.
Mr. G.B. aged 60, a very tall and stout person, had two ulcers, one of the size of a shilling upon the back of the leg just above the tendo achillis, the other rather less, on the outside of the leg; they were caused by his scratching the parts severely three months before; and he had used various remedies in the interval. There were some œdema of the leg to which he is subject, and much pain and inflammation of the ulcers. I directed the application of a cold poultice and lotion, and prescribed the pil. hydrarg. every second night with an aperient draught the following morning.
This plan of treatment was continued for a number of days without any appearance of healing in the ulcers. As the inflammation had subsided I proposed to adopt the mode of treatment recommended by Mr. Baynton, fearing that any attempt to heal the ulcers by eschar would fail on account of the œdema. This project was deferred, however, by the patient's wish to try the effect of sea-bathing. After a month's residence on the sea shore I was, on the return of my patient, again requested to examine these ulcers, which I found very nearly in the same state as before, only with the addition of some excoriations. I recommended the cold poultice for a few days to allay inflammation, and then tried Mr. Baynton's plan, dressing the leg myself daily; on the fourth day, however, the sore above the tendo achillis became so irritable that I was compelled to desist and to remove the plaster and bandage, and I again directed the cold poultice with rest, for a few days.
When the inflammation had again subsided, I ventured, notwithstanding the œdema, to apply the lunar caustic to form an eschar, enjoining rest and the horizontal position.