Caustic

“ Caustics are of different kinds, and of various powers, according to the reduction, or extirpation, for which they are intended. The actual cautery, {117} or red-hot iron, is used in firing, as well as for the farther prevention of sand-cracks already broke out. The antimonial caustic, or butter of antimony, (in judicious hands) , is a complete and perfect cure for poll evil, fistula, quittor, and canker in the foot. Lunar caustic is an admirable counteraction to warts, and fast-shooting fungus. Red precipitate is an excellent substitute, when so much strength is not required ”

“ CAUS′TIC. Syn. Caus′ticum, Escharot′i-cum, L. A substance that corrodes or destroys the texture of organised bodies. This action is popularly termed “burning.”
The principal caustics are nitrate of silver, caustic potassa, a mixture of caustic potassa and quick-lime, sulphate of copper, red oxide of mercury, verdigris, tincture of sesquichloride of iron, chloride of zinc, chloride of antimony, nitric acid, acetic acid, and carbolic acid. ”

“ This forceps is, I believe, the one which Paul describes as used for destroying the uvula with caustic. He says (VI. xxi) that if from timidity the patient decline excision of the uvula, we are to take the caustic used for operations on the eyelids, or some such caustic, and fill with it the hollows of the caustic holder for the uvula (τοῦ σταφυλοκαύστου τὰς κοιλότητας) , and directing the patient to gape wide, and getting the tongue pressed down with a tongue depressor, we open the instrument sufficiently and grasp with it as much of the uvula as we cut off in the other operation. ”

“ It is further to be particularly observed that the inflammation attendant on a recent wound is removed by the caustic, when the same degree of inflammation at a later period, and with suppuration, would be aggravated and [79] require the cold poultice and lotion, and render the formation of an adherent eschar impossible. ”

“ These are the only cases in which the caustic to a spherical reflector is a known curve; we may, however, without much difficulty, make out the kind of figure that it assumes in other cases, though the investigation of the equation is very tedious.
When the radiant point is at a finite distance without the circle, the form of the caustic is naturally intermediate to those already found. It is represented in Fig. 27. The caustic touches the circle at the points C, c where tangents from Q meet it, and it has a cusp at V, the focus of the principal reflected rays. ”

“ When the wart has a narrow neck it is best removed by tying a ligature of silk tightly round it, but when it has a broad base this treatment is not practical; then some mild caustic should be applied, as acetic acid, tincture of iodine, or a twenty-five per cent. solution of chromic acid. It is only necessary just to touch the wart with the caustic on the end of a wooden match once a day. When the wart is very large, it is best removed by being cut out and the skin wound brought together by a few stitches, and then treated as an ordinary wound. ”

“ It is improper to employ the caustic when the ulcer is too large to admit of the formation of a complete [20] eschar; or when it is so situated as to render it impossible that the eschar should remain undisturbed, as between the toes, unless, indeed, the patient be confined to his bed;—or in cases attended by much inflammation, or by much œdema. ”

“ Then rub the part thoroughly over with lunar caustic, and one effective operation of this kind will generally destroy the wart; if not, you cut off the black spot which has been occasioned by the caustic, and apply it again; or you may apply acetic acid, and thus you will get rid of it. Care must be taken in applying these acids, not to rub them on the skin around the wart.
WENS.—Take the yoke of some eggs, beat up, and add as much fine salt as will dissolve, and apply a plaster to the wen every ten hours. It cures without pain or any other inconvenience. ”

“ For the purpose of destroying cancerous ulcers, many caustics and escharotics have been proposed, such as the arsenic, corrosive sublimate, lunar caustic, &c. Of these no one seems to possess a preference over the rest, if we consider only their local action; but some of them, especially arsenic, are apt to produce bad effects, and that very unexpectedly, on the constitution. ”

“ If the second medium be more highly refractive than the first, the secondary caustic is a hyperbola having the same focus and centre as before, and the caustic is the evolute of this curve. When the refracting curve is a circle and the rays emanate from any point, the locus of the secondary caustic is a Cartesian oval, and the evolute of this curve is the required diacaustic. ”

“ In the first and second stages of the disease, before the ulcers have formed sinuses into the sole, and wholly or partly destroyed its structure, the best application is a saturated solution of blue vitriol—sulphate of copper. In the third stage, when the foot is a festering mass of corruption, after it has been cleansed as already directed, it requires some strong [222] caustic to remove the unhealthy granulations—the dead muscular structures—and to restore healthy action. Lunar caustic, which is preferable to any other application, is too expensive ”

“ When blood mingles with the exudation, a careful examination, with a speculum, if required, must be made; and the diseased surface should be touched with lunar caustic, or sulphate of copper. After this, an injection of the chloride of zinc, one grain to distilled water one ounce, should be employed thrice daily.
Should, however, the growth be of any size, it should be snipped off with a pair of probe-pointed scissors; and the lunar caustic ought then to be applied and repeated when the bleeding has entirely ceased. ”

“ William Chantry, aged 50, received a stab in the wrist with a hay-fork yesterday and applied a poultice; to-day there are great pain and swelling, and the wounded orifice is very small. I applied the lunar caustic within the puncture, and directly a cold poultice to be worn over it ”

“ The gold-beater's skin is more useful as a protection to the unadherent than to the adherent eschar, as the former would be more liable to be torn off by accident than the latter. The gold-beater's skin must be removed in the manner already described, whenever the subjacent fluid is to be evacuated, and must be reapplied after touching the orifice with caustic. ”

“ 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. ”

“ So saying, he bowed with great solemnity all round, and retired to his own lodgings, where he applied a caustic to the wart; but it spread in such a manner as to produce a considerable inflammation, attended with an enormous swelling ”

“ When EQ=2/3AE, (Fig. 120.) the segment of a circle just touches the sphere; all rays incident on Am are refracted accurately, so as to meet in q· (Aq=5/2AE) . The other rays falling on am form a caustic mq′· (aq′=1/4aE) . From this last place of Q to the centre, the caustic takes a form of the kind shown in Fig. 121., in which EQ is half the radius, q is on the surface qq′=2/5qE. When Q is at the center, of course there is no caustic other than that point itself: afterwards we find the figures described above, only that their places are inverted. ”

“ These are preferable to a hot iron, which the ancients used, because a hot iron forms a crust that acts as a defence to the under parts instead of destroying them. The lapis infernalis is much better than any other caustic, as it melts and penetrates during its application. The bitten part must be destroyed to the bottom, and where there is any doubt that the bottom of the wound is not sufficiently reached, butter of antimony should be introduced occasionally as deep as possible, and incisions should be made, if necessary, to lay open every part to the influence of the caustic. ”

“ Many slaves die of it, and its periodical discharges of bloody ichor makes me suspect it to be a development of fever. I have found lunar caustic useful: a plaister of wax, and a little finely-ground sulphate of copper is used by the Arabs, and so is cocoa-nut oil and butter. These ulcers are excessively intractable, there is no healing them before they eat into the bone, especially on the shins.
Rheumatism is also common, and it cuts the natives off. The traders fear these diseases, and come to a stand if attacked, in order to use rest in the cure. ”

“ If caustic be not at hand, the wound may be seared over with red-hot iron, which will answer as good a purpose, although much more painful in its operation. Mr. Blaine, in closing his able and scientific article on this subject, very justly remarks,
"Would I could instil into such minds the uncertainty of the disease appearing at all ”

“ These caustics are exactly analogous to those before treated of, being formed by the successive intersections of refracted rays, as those were by reflected ones.
Prop. Required the caustic to a plane refracting surface.
Let QR (Fig. 104.) represent an incident ray, qRS the refracted one; AM, MP are the rectangular co-ordinates of a point P on that line; PN is parallel to AM.
Then tan θ′=NR/NP=AR−MP/AM=∆tanθ−y/x,
xtanθ′−∆tanθ+y=0. ”

“ Discoloration caused by such practice is of little consequence, as desquamation must follow. It is questionable how far it may be safe to apply lunar caustic to any extensively inflamed surface, more especially of the head and face, lest metastasis should occur. The inflammatory action in the skin is subdued by the application, whilst it may advance, in the cellular tissue, to suppuration and sloughing, if other means are not adopted; and from the hard and blackened state of the cuticle, the condition of the subjacent parts is not readily perceived. ”

“ For such [97] sores are very apt to spread and to remain long very troublesome.
An old gentleman came to me with an oblong ulcer on the shin about an inch in length; it was very painful and inflamed. I applied the lunar caustic to form an eschar and requested him to call on the following morning. He did not come, however, but on seeing him the next day it was requisite to evacuate a little fluid; this was repeated on they third day, after which period the eschar remained adherent, and the part totally free from pain. ”

“ Celsus recommends excision with the knife and the application of cauteries or strong caustics afterwards. (vi, 19.)
Aëtius and Oribasius trust to septic and caustic applications without an operation. Antyllus (apud Rhasis Cont. xxxvi,) recommended excision and burning when the discharge from the ulcer is fetid.
Albucasis, like our author, recommends us to cut off the piece of nail that is attached, and then to apply a burning iron to the part. The burning, he adds, is of great consequence. When the bone is diseased he directs us to take it out, which generally may be done at the joint. ”

“ H., in various other affections; as in inflammation of the fingers; in the fungous ulcer of the navel in infants; in tinea capitis, &c. In this last case, we have ourselves used it with marked advantage. In all cases, the lunar caustic has a decided effect in diminishing the irritability of the parts to which it is applied; and hence should usually be preferred for the purpose of forming a "scab," for such the eschar really is, in a practical view; and we think that our author has hardly done justice to nature's methodus medendi by "scabbing;" ”

“ He was a keen observer of disease, and a dear lover of his profession, and he had paid great attention to rabies—dog madness. He and his assistants had been repeatedly bitten by rabid dogs; but knowing that he was in possession of an infallible preventive remedy, he never dreaded the wounds inflicted either upon himself or upon his assistants. Mr. Youatt never knew lunar caustic, if properly and immediately applied, to fail. It is, of course, only a preventive. If hydrophobia be once developed in 267the human system, no antidote has ever yet, for this fell and intractable disease, been found. ”