inadmissible, the caustic
is invaluable; in these cases the cold poultice and lotion should
precede the application of the caustic, for a few days, that the
irritability and inflammation of the sore and surrounding skin may be
first subdued; and after the eschar is formed, the part must be kept
exposed to the air and defended from external injury, by enjoining the
patient to wear trowsers and to be careful not to disturb the eschar.

The plan of curing ulcers is exactly what has been described in the
treatment by the unadherent eschar. For in these cases the eschar is
generally unadherent at first. It is necessary therefore in all cases,
except those of very small ulcers, to examine the eschar, making a
small puncture or rather smooth incision in its centre, so as to
evacuate the subjacent fluid if there be any, taking great care not to
break down or bruise the eschar so as to leave its inferior surface at
all ragged. This operation should be repeated daily until the eschar
proves to be quite adherent. And if the ulcer be rather large, rest
should be enjoined until the adherent eschar be fully and safely
formed, and a dose of saline purgative may be interposed. It must also
be particularly borne in mind, that the eschar must be constantly
defended by the gold-beater's skin, which must be removed and
reapplied at each examination.

I have here spoken of ulcers upon the legs. But the same observations
apply to ulcers on other parts of the body, and these are, in general,
far more manageable than the former, and do not require the same rest
during the unadherent state of the eschar.

CASE XXI.

Mrs. Butcher, aged 52, has two ulcers a little above the outer ankle,
one the size of half-a-crown, the other, of a shilling, of four months
duration, which are now in a healing state by the application of
cerate and poultice; the healing process is going on very slowly.
These ulcers were caused by a fall which bruised the part but made no
wound at the time; two small spots, which she compared to the pustules
of small-pox, formed, broke, and gave rise to the ulcers. I applied
the lunar caustic to form eschars.

At this time I had not begun to defend the eschar by the gold-beater's
skin, and in consequence both these eschars were torn by the patient's
stocking having adhered to them, and there was an oozing of fluid from
the centre of each eschar on examination on the following day. I again
applied the lunar caustic.

On th