ON SUBCUTANEOUS SURGERY. 3 



2. That the operation must be performed quickly and ncatl}', 

 with decision rather than force, and with as little disturbance 

 to the soft parts as possible. 



3. That the wound must be immediatel}' closed, and a 

 compress and bandage applied so as to support the part and 

 prevent the effusion of blood under the skin. 



4. That perfect quiescence to the i:)art be insured for three 

 or four days, and the dressing remain undisturbed. 



"When all these conditions are strictly observed, it matters 

 little whether large muscles, tendons, ligaments, or bones are 

 divided, or even whether the large joints of the body are 

 opened ; there is no better established fact in surgical practice 

 than that subcutaneous wounds seldom inflame or suppurate 

 when the above-named conditions are fulfilled. 



The influence of the exposure to air upon the reparative 

 process in wounds seems first to have attracted the attention 

 of that distinguished surgeon and physiologist, John Hunter, 

 who, observing the vast difference as to the healing process in 

 wounds exposed to the air and wounds not exposed to tlie air, 

 was so deeply impressed with the importance of the subject, as 

 to make it the basis of his classification of wounds and injuries. 

 John Hunter, in his " Treatise on the Blood, Inflammation, 

 and Gunshot Wounds," published in the year 1794, points 

 out as a great fundamental principle, in reference to the 

 healing of wounds, the difierence between two forms of injuries, 

 of which one is subcutaneous and the other open to the air. 

 He says : " The injuries done to sound parts I shall divide 

 into two sorts, according to the effects of the accident." 



" The first kind consist of those in which the injured parts 

 do not communicate externally, as concussions of the whole 

 body or of particular parts, strains, bruises, and simple 

 fractures, either of bone or tendon, which form a large 

 division. 



" The second consists of those which have an external 



