About the usual time the eschars separated, leaving a small point of the size of a pin's head, unhealed; this I again touched with the caustic. The case required no further attention.
This case leads me to caution my readers always to examine the parts carefully after the separation of the eschars, and if there be the slightest ulcer remaining to apply the caustic to it.
Case XXVII.
Mrs. Wakefield, aged 36, had an extensive ulceration with excoriation on the upper part of the right breast, of two months continuance; it had been greatly aggravated by improper treatment. I applied the lunar caustic over the whole ulcerated and excoriated surface. It gave much pain.
On the following day I was concerned to find that part of the eschar had been separated by the patient's dress. I repeated the application of the caustic and again directed the part to be exposed and carefully protected from being disturbed. The breast required to be supported being full of milk.
On the succeeding day an adherent eschar existed over all the ulcerated parts, and the pain, redness, and irritation had nearly subsided.
On the fourth day there was still less pain and inflammation. On the eight the eschars had separated and the breast was quite well.
Case XXVIII.
Mrs. U. aged 60, has been subject to ulcerated legs for several years. She has one ulcer on the outer ankle of the size of a shilling, and another behind it of the size of a horse-bean; they have been extremely troublesome and under surgical treatment for the last year, but during the last few weeks she has tried cerate, poultice, and the cold lotion. The leg is much swollen and inflamed, the redness extending several inches round the wound and over the instep; the œdema increases towards night. She has been in the habit of taking saline purgatives frequently.
I directed my patient to continue the cold poultice and lotion, and to rest completely for several days. At this period, the inflammation having somewhat abated, I applied the lunar caustic to form eschars and protected the parts with gold-beater's skin.