1917] 



on The Treatment of War Wounds 



Tube 3 is, as you see (Fig. 10), a 

 into a number of hollow spikes to 

 wound 



tube which has been drawn ou t 

 imitate the diverticula of the 

 My colleague. Dr. Alexander Fleming, its author and 

 inventor, calls this form of tube the "artificial war wound." To 

 imitate the conditions obtaining in the actual war wound we fill both 

 the tube and its diverticula with an infected trypsinised serum. We 

 now empty the tube, leaving behind of necessity in the diverticula a 

 certain amount of the original infected fluid. We then fill with an 

 antiseptic ; and the future of the infection will now depend on the 

 penetrating power of the antiseptic. If the antiseptic penetrates into 

 the infected fluid sterilisation will be obtained ; if it fails to penetrate. 



Fig. 10. — A test-tube standing on spike legs, representing a 

 war wound with diverticula. 



microbes will survive. To test our result we empty out the antiseptic, 

 refill with trypsinised serum, and incubate. 



After asking in Tube 3 whether the antiseptic can completely 

 sterilise a wound which has its recesses filled with an infected albu- 

 minous fluid, I go on in Tube 4 to investigate the question as to how 

 far the antiseptic can penetrate into the walls of the wound. Tube 4 

 is, as you see, a tube with hollow spikes. I have coated the inside 

 with infected serum agar, and the spikes provide in their hollows a 

 greater depth of infected lining and also a securer purchase for the 

 serum agar. The prepared tube is filled with antiseptic. We then 

 after an interval pour out the antiseptic, fill in with nutrient broth 

 or trypsinised serum, and incubate. Any microbes which have been 

 left alive in the lining will now grow out into colonies which can 

 be inspected through the walls of the tube. 



