"Ulcers lasting a year or longer cause the underlying bone to be eaten away and the resulting scars are depressed.' 'What drugs will not cure, the knife will; what the knife will not cure, the cautery will; what the cautery will not cure must be considered incurable."
Hippocrates' book of Aphorisms (46 BC)
Many treatments were also sought:
“The Medical times and gazette. J. & A. Churchill, London, 1860” (Surgery carried out in 1846)
“a paper by Mr, Spencer Wells, published in the volume of this Journal for 1854, page 211, The following is his report of the case:-
"He was a man, aged 35; he suffered for twelve years with an obstinate ulceration of the face. After the application of arsenic and cinabar it healed, but left a flat tumour, having many of the characters cheloid, but soft, and apt to bleed on slight injury. I surrounded it by four incisions, as shown in the first engraving,carrying the two side cuts obliquely downward to a distance somewhat greater than the breadth of the defect to be covered after the removal of the tumour. They are scarcely brought low enough in the drawing.
I then carefully removed every part of the tumour, and dissected the flap from its connexions, taking care not to detach the adipose tissue; some small vessels required torsion; iced water was used to suppress oozing of blood. The flap was then drawn upwards, and fixed by sutures, as seen in the second engraving. Water dressing was applied. Every part of the flap united by first intention, except a small portion at the upper and inner angle, but that healed by granulation and the cicatrix was scarcely perceptible. The third engraving shows the appearance of the patient a few months after operation. No return of the tumour or the unhealthy ulceration took place.“
Mr. Wells has informed me that this operation was performed in 1846 that the patient died abroad in 1858 or 1859 never had any return Mr Wells also informs me that he replaced part of one ala of a nose lost by rodent ulcer, by gliding over the skin of the opposite side of the nose, and fixing it to the edges of the defective part. “
This characteristic representation of "Jacob's ulcer" is after a daguerreotype by Glukman and a drawing from life by Mr. Forster. The woman, who was aged 35, had suffered under this frightful affection for eighteen years. She had been originally in my wards in Jervis-street Hospital, and was afterwards in the Hospital for Incurables, under the care of Professor Geogheghan; the right eye was at this time completely destroyed, and the ulceration was extending slowly but surely to the left.
"Lupus is preeminently a disease of the lower classes; it occurs more frequently in some parts of the country than in others, but it attacks individuals indiscriminately any where, without distinction of sex."