214 BIOLOGICAL PROBLEMS 



simple washing with warm saline. The surfaces are 

 found to be covered by vigorous granulation tissue. 

 The wound may be sutured or skin-grafted, and heal- 

 ing is uninterrupted. 



This is the course of successful salt-pack treatment. 

 By all the theories of the physiological school the 

 lymphagogue and leucocyte stimulation by the action 

 of the salt should result in the subjugation of the 

 bacterial flora infecting the lesion, but numerical 

 analysis of the flora, at all stages of the treatment, 

 reveals undiminished numbers of organisms up to 

 the time of removal of the packs. There is evidently 

 more in the treatment than meets the eye ; but yet 

 no theoretical explanation of these observed facts has 

 been forthcoming. 



One of the most clearly apprehended points in 

 salt-bag treatment is the terrible odour, which is ac- 

 companied by blackening of the injured tissue, scar- 

 ing the old-fashioned surgeon with visions of gan- 

 grene. Far from that it is the signal that all is going 

 well. Major Leonard Joyce, of Reading, was the 

 first to observe that stench and cure go hand in hand. 

 No smell, no blackening; no blackening, no cure. 

 Here lay the key to the puzzle. Following his obser- 

 vation, the matter was investigated bacteriologically 

 under the inspiration and direction of Dr. Robert 

 Donaldson, 1 the bacteriological specialist, and it was 

 found in the laboratory that from the pus of success- 

 ful cases a large oval-spored anaerobe of a strongly 

 proteoclastic nature could invariably be isolated, 

 while it was just as invariably absent from the un- 

 successful cases, which did not smell. This was 

 christened "the Reading bacillus". It remained to 

 determine the relationship of the bacillus to the treat- 



1 See the preliminary account by Dr. Donaldson and Major Joyce in The 

 Lancet of 22nd September, 1917. 



