TREATMENT OP WOUNDS 117 



after week with antiseptic infections is useless, until the 

 cause of the suppuration is removed. This, of course, 

 is elemental and well known, but is well worth repeat- 

 ing. Sometimes it is not advisable to operate too early 

 after the acute inflammation has receded because the 

 process of sequestration may not have progressed far 

 enough to enable one to cut out all that will eventually 

 amputate itself from the living tissues. Thus a suppura- 

 tion supervening a calked coronet points to quittor, but 

 if we operate at once there is found no guide to the 

 area of necrosis in the cartilage. After a little procras- 

 tination the necrotic area will become distinguishable 

 from the healthy surrounding and can be removed suc- 

 cessfully. The same may be said of suppurating 

 processes due to exfoliation of bone particles. If a hasty 

 reaction is made, separation is not complete, and a second 

 operation will be required. 



Approaching the final stage of healing, venomous 

 wounds do not behave as well as aseptic wounds. The 

 granulations of an aseptic wound grow safely and evenly 

 to maturity like a healthy tree, while those of infected 

 wounds are erratic in their behavior. Some may become 

 indolent and others exuberant. Indolent granulations 

 (ulceration) are rare in animal wounds except from im- 

 proper treatment — treatment that stunts them. The 

 continued use of strong antiseptics or the too early resort 

 to astringents (alum powders, for example) are very 

 harmful to wounds. They prevent the cells from grow^ 

 ing toward a healthy maturity and delay healing. 

 Astringents are not indicated until the granulations are 

 level with the surface of the body ; then they are needed 

 to prevent the formation of a protruding scar. Com- 

 mon white lotion or white lotion with the addition of a 

 small amount of copper sulphate is hard to improve upon 

 as an astringent for the last stages of sclerogenesis. 



