through a considerable angle. Here the antiseptic principle had
effected the restoration of a joint, which, on any other known
system of treatment, must have been excised.
Ordinary contused wounds are, of course, amenable to the same
treatment as compound fractures, which are a complicated variety
of them. I will content myself with mentioning a single instance
of this class of cases. In April last, a volunteer was
discharging a rifle when it burst, and blew back the thumb with
its metacarpal bone, so that it could be bent back as on a hinge
at the trapezial joint, which had evidently been opened, while
all the soft parts between the metacarpal bones of the thumb and
forefinger were torn through. I need not insist before my present
audience on the ugly character of such an injury. My house-
surgeon, Mr. Hector Cameron, applied carbolic acid to the whole
raw surface, and completed the dressing as if for compound
fracture. The hand remained free from pain, redness or swelling,
and with the exception of a shallow groove, all the wound
consolidated without a drop of matter, so that if it had been a
clean cut, it would have been regarded as a good example of
primary union. The small granulating surface soon healed, and at
present a linear cicatrix alone tells of the injury he has
sustained, while his thumb has all its movements and his hand a
fine grasp.
If the severest forms of contused and lacerated wounds heal thus
kindly under the antiseptic treatment, it is obvious that its
application to simple incised wounds must be merely a matter of
detail. I have devoted a good deal of attention to this class,
but I have not as yet pleased myself altogether with any of the
methods I have employed. I am, however, prepared to go so far as
to say that a solution of carbolic acid in twenty parts of water,
while a mild and cleanly application, may be relied on for
destroying any septic germs that may fall upon the wound during
the performance of an operation; and also that, for preventing
the subsequent introduction of others, the paste above described,
applied as for compound fractures, gives excellent results. Thus
I have had a case of strangulated inguinal hernia in which it was
necessary to take away half a pound of thickened omentum, heal
without any deep-seated suppuration or any tenderness of the sac
or any fever; and amputations, including one immediately below
the knee, have remained absolutely free from constitutional
symptoms.
Public-domain text, read in full here on John Shaqi.
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