TREATMENT OF WOUNDS 109 



we are not justified in depending entirely upon our 

 mechanical disinfection to prevent tetanus. 



Wounds That Cannot Be Drained by Gravitation of 

 the Discharges — Open Wounds 



This group includes both the surgical and the acciden- 

 tal wounds located at the summit of a region. The trau- 

 matic cavity points upward and its bottom is too far 

 from the surface of the body to drain downward. It 

 includes the surgical wound of radical poll-evil opera- 

 tions and some operations for fistula of the withers, quit- 

 tors, and all the accidental wounds of the back, loins, 

 croup, and heels. Almost all other w^ounds besides these 

 can be drained and treated by the method previously 

 described. The surgical wounds of this kind are often 

 invasions of badly infected places, but the aim of the 

 operation in each case is to remove en masse the microbe- 

 laden structures. 



Thus in poll evil, although we start wdth a badly 

 infected mass of tissue and tracts carpeted with infected 

 granulations, when the operation is properly done all of 

 these are safely removed and the cavity resulting, if not 

 entirely sterile, is in a fairly good state for the easy 

 destruction of the infection that remains. The same 

 may be said of all operations of this character. The 

 operation Jtself is the mechanical disinfection needed to 

 promote healing, and the performance of the operations 

 must be carried out with this end in view, for if we leave 

 our surgical wounds, made in infected structures, with- 

 out disposing of the original infection, or deposit more 

 in operating, these wounds will be difficult to manage. 

 They will heal slowly. The fact that we are operating 

 upon infected structures is never an excuse for unclean 

 surgery. These operations should be as clean as those 



