ire to be considered; and it will I
imagine be found of no little advantage, in all these respects, in
many cases which are incident to the soldier and sailor.
II. ON THE UNADHERENT ESCHAR.
The eschar is generally adherent in cases of recent injuries, and in
small ulcers, when they are nearly even with the skin and attended by
little inflammation. In other cases the eschar is too apt to be
unadherent, and this arises from the formation of pus or of a scab
underneath.
If the eschar be unadherent by subjacent pus, it may be ascertained in
the space of from twelve to twenty-four hours; the centre is generally
observed to be raised and to yield to the pressure of a probe;
sometimes the subjacent fluid has partly escaped by an opening at the
side of the eschar.
When a scab forms underneath the eschar, which does not happen except
the fluid has been allowed to remain too long under the eschar without
being evacuated, there are pain and some inflammation, the eschar does
not separate, but remains long over the sore, and there is no
appearance of healing.
When it is ascertained that there is fluid underneath the eschar, a
slight puncture is to be made by the point of a penknife, the fluid is
to be gently pressed out, and the caustic is then to be applied to
the orifice thus made. The same plan is to be adopted if the fluid
ooze out at the edge of the eschar; it is to be fully evacuated by
pressure, and the orifice is to be touched with the caustic. The
healing process goes on best however when the orifice is in the centre
of the eschar. After this treatment the eschar occasionally remains
adherent, but more frequently the fluid requires to be evacuated
repeatedly, and this should be done every twelve hours, or once a day,
according to the quantity of fluid formed, taking care that the eschar
be not needlessly separated by allowing the fluid to accumulate
underneath. If, from accident, the eschar is separated before the sore
be healed I would reapply the caustic. At length the eschar becomes
adherent, and in due time begins to peel off, leaving the surface
healed.
In every case in which the eschar does not separate favourably, I
begin to suspect the formation of a scab underneath, in which case the
whole must be removed by the application of a cold poultice for two or
three days; this has not only the effect of removing the eschar but of
allaying any inflammation or irritation; afterwards the caustic must
be rea
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