408 HEALTH AND DISEASE 



and form, as they will, a complete defensive covering or scab. In this con- 

 dition all foreign substances which would irritate and inflame the wound 

 are excluded from it, and so long as this state continues, healing proceeds 

 rapidly without interruption. Anything, however, that inflames and pro- 

 vokes the formation of pus (matter) beneath the scab, interferes with the 

 process and delays repai-ation. 



GENERAL TREATMENT OF WOUNDS 



As wounds vary in their nature and character, the details of treatment 

 require to be modified accordingly. There are, however, certain general 

 principles applicable to wounds of every description which must be observed 

 if treatment is to be made a surgical success. In this connection the chief 

 objects to be attained are: — (l) To arrest haemorrhage; (2) to cleanse 

 thoroughly and free the wound from all dirt and foreign matter; (3) to 

 render the broken surface aseptic; (4) to bring the divided parts into 

 close apposition with each other and retain them in that position; (5) to 

 exclude all dirt and micro-organisms from the wound after adjustment; (6) 

 to prevent movement of the part and avoid all other sources of irritation. 



A certain amount of inflammatory action results when a wound is 

 inflicted, and this will be greater or less according to its size, the 

 period of exposure after infliction, and the mode of production. Serious 

 inflammation tends to retard healing, and should therefore be kept under 

 control as far as is practicable. The common practice of applying hot 

 oils to wounds is much to be deprecated, inasmuch as they produce inflam- 

 mation and increase the discharge of pus, and interfere with the healing 

 process. 



Arrest of Bleeding. — The method to be adopted for this purpose 

 will depend upon the size of the divided vessels. When these are small, 

 the less the part is interfered with the better. A short period of exposure 

 to cold air will usually suffice to stop the flow; should it fail, the edges of 

 the wound may be brought together with gentle pressure, or the wounded 

 surface may be irrigated with clean cold water, or pressed upon for a 

 minute or two by a pad of clean lint or cotton-wool soaked in a solution 

 of tincture of iodine in the proportions of 20 drops to the ounce of water. 



When the htemorrhage is profuse, and the blood spurts out or flows 

 away from certain points of the wound in distinct streams, the divided 

 vessels must be sought for, and either twisted, or raised with forceps and 

 tied round with aseptic gut or silk. It should be pointed out, however, 

 that ligatures tend to retard the healing of wounds, and where possible 

 should be dispensed with. 



