COMPOUND FRACTURE, ABSCESS, ETC. 7 



sore without the sHghtest suppuration, just as in ordinary heaUng by scabbing. 

 This case is interesting, not so much because the compound fracture was con- 

 verted into a simple one, for this might have occurred under ordinary treatment, 

 but because it showed that in any case of fracture comphcated with a small 

 wound, we have in carbolic acid a means which enables us to disregard the 

 wound altogether after the splints have been applied, instead of being under the 

 necessity of daily disturbing the apparatus to change the dressing. 



At length a case presented itself well calculated to test the value of carbolic 

 acid in compound fracture. 



Case 3. — John H , aged twenty-one, a moulder in an iron foundry, was 



admitted on the 19th of May, 1866, with compound fracture of the left leg, pro- 

 duced in the following manner. He was superintending the raising by crane of an 

 iron box containing sand ready for a casting, the box and its contents weighing 

 about 12 cwt., when one of the chains by which it was suspended slipped, and 

 the box fell from the height of four feet with unbroken force upon the inner 

 side of his leg, which was planted obliquely beneath it. Both bones were 

 fractured, the tibia about its middle, and a wound an inch and a half in length, 

 and three-quarters of an inch broad, was made at the inner aspect of the limb, 

 on a level with the fracture of the tibia, and obviousl}^ communicating with it. 

 At the same time the soft parts generally were much contused, as was evident 

 from the great distension of the limb with extra vasated blood. Dr. A. Cameron, 

 my house surgeon, finding, on manipulating the limb, that bubbles escaped 

 along with the blood, implying that air had been introduced during the move- 

 ments of the leg as the patient was being carried to the infirmary, thought it 

 best that I should see the case, which I did at three p.m., three hours and a halt 

 after the accident. In order to expel the air I squeezed out as much as I could 

 of the clotted and fluid blood which lay accumulated beneath the skin, and 

 then applied a bit of lint dipped in carbolic acid slightly larger than the wound, 

 and over this a piece of sheet-tin about four inches square. Finally the limb 

 was placed in pasteboard splints, resting on its outer side with the knee bent. 

 At eight p.m. some more acid was added with another piece of lint, so that 

 the crust of clots, carbolic acid, and lint was about one-third of an inch in thick- 

 ness. A hot fomentation also was applied over the inner aspect of the leg, the 

 crust being protected by the tin. Next day he was pretty easy, and had passed 

 a quiet night, though occasionally awakened by starting pains ; the pulse was 90, 

 but he took some food with relish. The surface of the crust was touched again 

 with carbolic acid, and the fomentation was continued, and in place of tht 

 internal pasteboard splint, a large sheet of tin was applied over the flannel 



