An Essay on the Application of the Lunar Caustic in the Cure of Certain Wounds and Ulcers

by John Higginbottom

In erysipelatous inflammation, where vesicles are formed, the caustic does injury, as in recent burns.

I have always found that the caustic has done injury in boils, aggravating rather than diminishing the affection.

1. Of Burns.

The application of the lunar caustic in recent burns or scalds, has always appeared to me to increase the inflammation and vesication, even inducing blisters where there were none before. The caustic must not, therefore, be applied in these cases, until the inflammation has entirely subsided; but when there remains only a small superficial ulceration, the caustic may be passed lightly over the ulcerated surface to form an eschar which is to be defended by the gold-beater's skin; for the affection is then reduced to the state of a common superficial ulcer. An adherent eschar is generally readily formed, and no further application is required. If the ulceration be more extensive and deeper, the lunar caustic may be applied, and the eschar treated, exactly as in common ulcers.

It may be well to illustrate these points, by the following cases.

Case XXXIII.

A little girl, aged 10, scalded her breast a week ago and has treated it with the ordinary remedies. There remained a superficial ulceration of the size of half-a-crown. I applied the lunar caustic lightly over the surface of the sore, and then the gold-beater's skin.

On the following day, an adherent eschar had formed, and in five days more it dropped off leaving the ulcer quite healed.

Case XXXIV.

Mr. C. aged 51, scalded his leg ten days ago on the instep. He applied ointments and poultices. The surface remained ulcerated to the extent of three inches in length and an inch and a half in breadth, and presented a considerable thick slough in the centre; the inflammation continued to be considerable with some œdema towards the toes. In such a case I should now recommend a cold poultice to be applied for several days; but the present case occurring early in my trials of the caustic, the latter remedy was applied forthwith over both the ulcer and slough.