116 WOUND TREATMENT 



In discussing the management of venomous wounds, 

 along this vein of non-interference, I was once chided by 

 a student for performing the radical operation for infec- 

 tion of the navicular sheath from a nail prick, on the 

 ground that my arguments and practices were discrep- 

 ant. When the objects of this operation are analyzed, 

 however, it is made plain that the whole procedure is 

 nothing more than the drainage of a pent-up sero- 

 purulent collection in the sheath cavity. The apparent 

 radical part of the operation is the invading dissection 

 required to reach the hot-bed of the infectious wound. 



Wiping out venomous wounds frequently with clean 

 wads of cotton, keeping the surroundings free from desic- 

 cated discharges and dusting freely and often with an 

 antiseptic (non-astringent) powder I have found to be 

 the best, and the most practical treatment. 



The resort to bacterins should not be ignored ; the best 

 surgeons are using them. In one of the largest surgical 

 clinics in Chicago a bacterin is made in every pus case, 

 and as this practice is now of some years' standing, it is 

 very evident that benefit is derived from the bacterins, 

 for otherwise the practice would long since have been 

 discontinued. 



Whenever suppuration continues beyond the active in- 

 flammatory stage, after all local and systemic phenomena 

 attending the process have ceased to exist, then the 

 wound treatment must be directed toward the underlying 

 cause. Foreign bodies, sloughs, sequestra, exposed liga- 

 ments, tendons, cartilage and tooth roots, channels be- 

 tween layers of muscles, or outer integument extending 

 in a downward direction, are a few of the many things 

 capable of perpetuating a suppurative process. It is the 

 surgeon's duty to "hunt these out" and to correct mat- 

 ters whenever any of these elements are found to exist. 



Treating suppurating tracts day after day and week 



