134 WOUND TREATMENT 



not object to it, especially when they find they can 

 obtain it for the asking. I have also given it in doses 

 of one to two ounces internally, though with doubtful 

 effects. 



For painful wounds and ulcers generally a simple 

 dressing kept wet with warm normal saline solution 

 seems most useful. The patient appreciates it better if 

 he is given normal salt tablets (which, by the way, make 

 real imitation plasma), rather than being directed to 

 dump a teaspoonful of common salt into a dish of 

 w^ater. 



For ugly, painful old varicose ulcers a boon to the new 

 doctor on the case is orthoform, applied either as a dust- 

 ing powder or in five-per-cent ointment. Some patients 

 will develop erythema from orthoform, much like those 

 formerly common when iodoform was in use. 



For exuberant granulations — "proud flesh," as pa- 

 tients seem to call it — I like the scissors. It can usually 

 be trimmed off without discomfort. If this is not per- 

 missible, then firm pressure is the next method of choice. 

 My experience with silver nitrate has been uniformly 

 unsatisfactory. So far as I can see, silver nitrate merely 

 musses up the field of operations and stimulates the gran- 

 ulations to renewed activity. The clean, prompt, effect- 

 ual way to remove proud flesh is to cut it down. 



Carbolic acid, in any other role than as a cauterant, 

 is to be mentioned only to be condemned. There is 

 nothing known to domestic surgery that will delay heal- 

 ing of a simple wound like carbolic salve, unless it be a 

 fresh and reeking poultice of genuine cow dung. 



Antiseptics, other than cauterants or recognized disin- 

 fectants, might well be discarded from the office al- 

 together. We have little use for them. Once having 

 asepticized a wound, I am sure the best policy from that 

 point on is to avoid antiseptics and depend wholly upon 



