the
adherent eschar.

I now proceed to mention some other effects of the application of the
caustic. The first is that, in cases in which there would be much and
long continued irritability and pain, as in superficial wounds along
the shin, all this suffering, and its consequences in disabling the
patient, are completely avoided. A blush of inflammation forms around
the eschar, but this gradually subsides without any disagreeable
consequences, and the inflammation which would otherwise have been set
up is entirely prevented by the due formation of the eschar.

If inflammation be previously established, it is increased, at first,
by the application of the caustic. But if this inflammation be not
severe, and if the eschar remain adherent, all inflammation, both that
induced by the application of the caustic, and that existing
previously, entirely subsides. When the previous inflammation round
the ulcer is considerable, however, the application of the caustic
would induce vesication, and it should in such a case of course be
avoided, and another mode of treatment to be described hereafter must
be adopted.

I would introduce in this place some observations on the comparative
effects of healing by eschar and by scabbing. On the subject of
scabbing I must refer my reader to the well known work of Mr. John
Hunter. The advantage of healing by eschar over that by scabbing is
quite decided. By comparative trials, I have found that whilst the
scab is irritable and painful, and surrounded by a ring of
inflammation, the adherent eschar is totally free from pain and
inflammation; and that whilst the scab remains attended by
inflammation and unhealed, the eschar is gradually separating, leaving
the surface underneath completely healed. To these observations I may
add that the success of the plan of healing by eschar is infinitely
more certain as well as more speedy than that by scabbing.

I shall, in conclusion, briefly recapitulate the advantages of this
mode of treatment. In the first place, it will be found far more
efficacious and speedy than any other; secondly, it has the great
advantage of saving the patient much suffering and inconvenience; and
thirdly, it renders the repeated application of dressings and
ointments quite unnecessary. Its utility is extremely great,
therefore, where the time of the poor, the expense of an
establishment, and the labours of the medical officer, as well as the
sufferings of the patient, requ