ANAEROBIC TREATMENT OF WOUNDS 217 



out of the bags, and the concentration in the wound 

 at the end of twenty-four hours is not above 2 per cent. 



If, then, the Reading bacillus is simply a sporadic 

 organism, accidentally fostered by salt-packing, what 

 is its actual role in effecting cures? 



The increasing use of excision, imperfect though 

 that method is, shows that the vital importance of the 

 dead tissue in a wound is becoming more fully realized. 

 However small the trauma inflicted, some devitalized 

 tissue there must be, and the efficacy of either anti- 

 septic or saline treatment diminishes in proportion as 

 the amount of necrotic material present rises, so that 

 the cleansing of a wound really implies the removal 

 of the dead tissue, rather than its associated micro- 

 organisms. Antiseptic treatment, on the other hand, 

 aims simply at the poisoning of the organisms present, 

 and if the dead matter be abundant this is just what 

 no antiseptic surgically applicable can do. The dead 

 tissue forms the basis which gives the infecting organ- 

 isms foothold in the wound. So long as any organ- 

 isms at all remain alive, shielded, it may be, from 

 antiseptics by the adsorptive powers of the albuminoid 

 masses in which they are embedded, the infective 

 attack steadily continues. Decomposition products of 

 general toxicity may be liberated, and opportunity 

 afforded for the elaboration of the specific bacterial 

 toxins with which the adjacent but healthy tissues are 

 bombarded, their resistance lowered, and the area of 

 septic infection automatically spread. To remove the 

 dead tissues is to rob the enemy of his supply base, 

 and thus to circumscribe the development of the in- 

 vaders within limits which the resistant powers of the 

 body itself can quickly deal with, if they are properly 

 called forth, and not interfered with by the artificial 

 irritation of antiseptics. This relief of the tissues 

 from continued intoxication is, of course, what is 



