2 ON A NEW METHOD OF TREATING 



has probably been underrated, in consequence of the healthy state in which 

 granulating sores remain in spite of a very offensive condition of their discharges. 

 To argue from this, however, that fetid material would be innocuous in a recent 

 wound would be to make a great mistake. The granulations being composed 

 of an imperfect form of tissue, insensible and indisposed to absorption, but 

 with remarkably active cell-development, and perpetually renovated as fast as 

 it is destroyed at the surface, form a most admirable protective layer, or living 

 plaster. But before a raw surface has granulated, an acrid discharge acts with 

 unrestrained effect upon it, exciting the sensory nerves, and causing through 

 them both local inflammation and general fever, and also producing by its 

 caustic action a greater or less extent of sloughs, which must be thrown off by 

 a corresponding suppuration, while there is at the same time a risk of absorption 

 of the poisonous fluids into the circulation. 



This view of the cause of the mischief in compound fracture is strikingly 

 corroborated b}' cases in which the external wound is very small. Here, if the 

 coagulum at the orifice is allowed to dry and form a crust, as was advised by 

 John Hunter,^ all bad consequences are probably averted, and, the air being 

 excluded, the blood beneath becomes organized and absorbed, exactly as in 

 a simple fracture. But if any accidental circumstance interferes with the 

 satisfactory formation of the scab, the smallness of the wound, instead of being 

 an advantage, is apt to prove injurious, because, while decomposition is per- 

 mitted, the due escape of foul discharges is prevented. Indeed, so impressed 

 are some surgeons with the evil which may result from this latter cause, that, 

 deviating from the excellent Hunterian practice, they enlarge the orifice with 

 the knife in the first instance and apply fomentations, in order to mitigate the 

 suppuration which they render inevitable. 



Turning now to the question how the atmosphere produces decomposition 

 of organic substances, we find that a flood of hght has been thrown upon this 

 most important subject by the philosophic researches of M. Pasteur, who has 

 demonstrated by thoroughly convincing evidence that it is not to its oxygen 

 or to any of its gaseous constituents that the air owes this property, but to 

 minute particles suspended in it, which are the germs of various low forms of 

 fife, long since revealed by the microscope, and regarded as merely accidental 

 concomitants of putrescence, but now shown by Pasteur to be its essential 

 cause, resolving the complex organic compounds into substances of simpler 

 chemical constitution, just as the yeast plant converts sugar into alcohol and 

 carbonic acid. 



A beautiful ihustration of this doctrine seems to me to be presented in sur- 



' See Works of J. Hunter, edited by Palmer, vol. i, p. 429. 



