tient
again.

IV. OF SOME ANOMALOUS CASES.

1. _Of Whitlow._

The lunar caustic is very useful in the treatment of this painful
affection. Patients seldom apply to the surgeon before suppuration has
taken place. It is then, I think, the best plan to open the abscess
freely, to apply the caustic well within the cavity, and then to
envelope the part by the cold poultice and lotion. In this manner the
pain and irritation are almost immediately removed, after the smart of
the caustic has subsided. A second application is seldom necessary.
In some cases, however, there is an increase of inflammation in a day
or two, which requires the caustic to be again applied. When the
inflammation has subsided, the loose cuticle may be removed, and the
caustic must be applied to form an eschar.

In slight cases the lunar caustic may be passed over the inflamed
part, and in this manner suppuration and the continuance of
inflammation is often prevented.

In those cases in which the suppuration is artificial and attended
with severe diffused inflammation, the pus should be evacuated and a
cold poultice applied for a day or two; for the too early application
of the caustic would only add to this kind of inflammation; see p. 11;
afterwards the skin may be removed, and if there be excoriations the
caustic may be lightly applied.

2. _Of Inflammation of the Finger._

The following case of inflammation of the finger occurred without any
assignable cause.

CASE XXXI.

A young man, aged 18, came to me with a painful swelling of the
middle finger of the right hand; suspecting deep-seated abscess, I
made a free incision and evacuated a little pus. I then applied the
lunar caustic within the cavity and directed a cold poultice to be
applied with lotion.

On the fourth day my patient had returned to his occupation as a dyer.

CASE XXXII.

Miss B. aged 23, had a slight scratch on the inside of the index
finger, which issued in severe inflammation extending over the back of
the hand. I made a free incision in the part first affected, evacuated
a little pus, and directed a poultice to be applied.

On the following day, there was less pain but still great swelling at
the back of the hand, which, I think, would have been removed had the
caustic been used.

I now applied the caustic freely within the orifice.

On the following day there was less swelling and discharge.

Two days afterwards, the caustic was again applied, and