1 8 ON A NEW METHOD OF TREATING 



I determined to give the limb one last chance. Before he was taken to the 

 new ward, nitric acid was once more thoroughly applied. His nurse was directed 

 to change the poultice every three hours, and he continued to take wine and 

 some tonic medicine. His general health immediately improved, and when 

 the slough separated, the sore looked healthy. It was now dressed with lint 

 dipped in a solution of sulphate of copper, five grains to an ounce of water, and 

 over this a poultice, the whole being changed every three or four hours night 

 and day ; and under this treatment cicatrization proceeded rapidly. Yet 

 when the scar had attained a certain width, a tendency to vesication again 

 showed itself, threatening recurrence of the disease, and in order to prevent 

 the newly formed epidermis from acquiring poisonous qualities as it seemed 

 to do, I ordered the lint with the lotion, as well as the poultice, to be extended 

 over the whole cicatrix. From the time this dressing was adopted the progress 

 was uninterruptedly satisfactory till the 9th of January, when the sore was 

 at length entirely healed, and he was allowed for the first time to put his foot 

 to the ground. The contraction of the large cicatrix, involving at one part the 

 gastrocnemius muscle, had caused some bending of the knee and pointing of 

 the toes. The former has since become corrected spontaneously by his habitual 

 attitude, sitting in bed with the legs extended before him. The pointing of 

 the toes has also become diminished, and will probably soon pass off entirely, 

 without the division of the tendo Achillis, which I had in view. The tibia, 

 which has long been firm, is of precisely the same length as the other, and the 

 contour of the limb is natural. His general health also is excellent ; but he 

 was detained in the hospital till the 9th inst. (March 1867), on account of an 

 obstinate eczematous eruption on the integument of the leg irritated by the 

 long-continued poulticing. 



Case 6. — The following case terminated fatally, but from circumstances 

 of an accidental nature ; and I trust that the instruction to be derived from it 

 will not be interfered with by the unhappy ultimate result. 



John C , aged fifty-seven, a labourer, was working in a quarry at Row, 



near Helensburgh, on the Clyde, at nine a.m. on the 26th of October, 1866, when, 

 striking with a crowbar an overhanging part, he brought down an enormous 

 mass of stone weighing six or seven tons, which fell in large blocks on and about 

 him. His right thigh-bone was broken in its lower third, and, as afterwards 

 appeared, the end of the upper fragment was driven through the skin at the 

 inner aspect of the limb a little above the knee. The right collar-bone was 

 fractured at the same time, and he was severely contused in other parts. It 

 was long before his only companion in the quarry could extricate him from 



