ANTISEPTICS— PAST AND PRESENT 49 



employed for the purpose, although there is consider- 

 able difference of opinion as regards its germicidal 

 power. Whatever agent is used, a thorough cleansing 

 of the wound is essential. 



Unfortunately, we do not often get the chance to 

 attend to the first dressing of a wound, as the owner 

 or the attendant attempts the process on the occurrence 

 of the accident and far too frequently introduces infec- 

 tion. In the case of a deep punctured wound, in which 

 infection is probably deep-seated, and the external open- 

 ing small in size, it is necessary to carefully enlarge the 

 latter so as to carry out thorough irrigation. 



3. Removal of Foreign Bodies. — This is a procedure 

 that requires special attention. Wounds in hunters fre- 

 quently contain foreign bodies such as thorns, portions 

 of gravel, or other substances, and a careful search is 

 necessary in order to discover their presence ; if they are 

 overlooked, serious trouble will occur afterwards. 



4. Drainage. — Efficient drainage is of the greatest im- 

 portance. This is well exemplified by contrasting the 

 progress made by punctured wounds extending in an up- 

 ward direction, with those extending downwards. With- 

 out proper drainage, all other means will fail. To carry 

 this out efficiently in the case of extensive wounds is not 

 always an easy matter, but on it depends success or fail- 

 ure. Suitable openings must be made at dependent parts, 

 and the selection of drainage materials will depend on 

 circumstances. If gauze drainage can be employed, 

 care should be taken that the gauze does not act as a 

 plug and prevent the escape of discharge. In extensive 

 wounds, india-rubber drainage tubes are to be preferred. 

 The old-fashioned seton must be condemned, as it 

 causes irritation and increases suppuration. 



5. Sutures. — Careful consideration is necessary in or- 

 der to decide whether it is advisable to employ sutures. 



