ANAEROBIC TREATMENT OF WOUNDS 213 



that the saline produces an exosmosis of serous lymph 

 from the tissues, bathing the injured surfaces with 

 protective substances and chemotactically attracting 

 leucocytes in such numbers as to overwhelm invad- 

 ing organisms. There is no doubt that this marks a 

 great .advance on the antiseptic methods, and, with- 

 out necessarily accepting the physiological explana- 

 tions given of its action, one may admit its relative 

 efficacy. Nevertheless it has, in common with anti- 

 septic methods, two serious drawbacks which invali- 

 date it for war surgery. One is its cumbrous appli- 

 cation, which excludes it from field operations, and 

 the other is the slow progress of recovery in extensive 

 sepsis. 



To overcome these difficulties Colonel H. M. W. 

 Gray devised his method of packing with solid salt, 

 a method which perpetuates the merits of Wright's 

 treatment without its disadvantages, while the wound 

 follows more or less closely the same course of 

 changes which Wright lays down as essential to 

 proper healing. Presenting such obvious advantages, 

 this method has enjoyed wide popularity, and the re- 

 sults have been usually excellent. Even where old- 

 standing infections, with dirty, sloughy wounds, have 

 to be treated, with the patient frequently running a 

 high temperature and in great pain, the minimum of 

 operative interference is called for. After the intro- 

 duction of the packs the patient can be left for seven 

 to nine days without redressing, a great gain in rest 

 and mental quietude for him, to say nothing of the 

 surgeon. By the third day the temperature begins 

 to come down, the patient feels comfortable, and the 

 pain abates, even in most obstinate cases. When 

 the packs are removed, the wound is found to be 

 bathed in yellow pus, and the sloughs have been re- 

 duced at least to thin flakes which can be detached by 



