AN^ROBIC TREATMENT OF WOUNDS 219 



Our own laboratory investigations have been largely 

 intended to elucidate the physiological conditions 

 governing the growth and activity of the bacillus and 

 its relation to the pathogenic organisms and to anti- 

 septics, which we must speak of shortly. The treat- 

 ment which has so far given the best results is simply 

 that of sowing the wound (after washing out with 

 saline or water) with a culture of the organism either 

 active or in the passive sporing state, it does not 

 matter which, and then packing either with salt, if 

 the wound be deep, or sphagnum moss in the case 

 of wide-open injuries. The only reason for the sug- 

 gested differentiation is that sphagnum has a tendency 

 to swell in contact with serum unless it has previously 

 been well soaked, and this in a narrow cavity may 

 cause pain. If it has been soaked and wrung out of 

 sterile water it may be used just like the salt-packs, 

 whichever is most convenient, there is no difference 

 in effect. 



With salt the pain is transient, and the heavy out- 

 flow of serum very soon soaks the dressings, reducing 

 greatly the strength of salt in contact with the tissues. 

 One point must be carefully attended to. The wound 

 must be quite thoroughly opened up, so that the 

 culture and the packing may have free access to every 

 crevice. Failure can invariably be traced to insuffi- 

 cient opening, or to the presence of some unsuspected 

 sepsis progressing elsewhere unchecked. Without 

 opening and proper packing success cannot be looked 

 for. It is valueless to inject the organism into a closed 

 space, and, as gas is formed in the process of proteo- 

 lysis, may even be dangerous. When the packs have 

 been removed and things have gone well there is no 

 need to renew them, but simple saline dressings may 

 take their place, and measures be taken for closing 

 the wound in the usual manner. This is usually an 



