10 ON A NEW METHOD OF TREATING 



On seeing him about two hours afterwards, I sawed off the protruding 

 portion of the ulna, and the tags of muscle having been previously clipped away, 

 I apphed carboHc acid freely to the whole interior of the wound, including the 

 exposed surface of the bone ; and having straightened the radius, which gave 

 way during the process, placed the limb upon a wooden palmar splint. Avoiding 

 any attempt to approximate the lips of the wound, I covered it with a piece 

 of sheet-tin, sufficiently large to overlap the sound skin about a quarter of an 

 inch in every direction. The limb was fixed to the splint by a bandage, so 

 arranged as to permit the removal of the tin mthout disturbing the apparatus ; 

 and hot fomentations were applied over the whole. A few minutes after the 

 carbolic acid was applied he said he was perfectly easy. At seven o'clock he 

 asked for food, and took it. His pulse was then 84. At eight p.m. I saw him 

 again, and applied beneath the tin a piece of lint dipped in carbolic acid, about 

 as large as the wound. Noticing some distortion in the upper arm, I found 

 that the humerus also was broken in its lower third, and applied splints accord- 

 ingly, the limb being kept supported upon a pillow beside him. He slept a 

 good deal during the night, though moaning and starting occasionally. Next 

 day his pulse was 108 ; but he took his breakfast heartily, and the tongue was 

 healthy, while he complained only of a little uneasiness about the elbow, and 

 even this disappeared on changing the fomentation cloth. A piece of sheet-tin 

 was now arranged so as to form a sort of cover for the forearm, including the 

 hand. Being retained in position by looped bandages, it increased the steadi- 

 ness of the limb, while it ensured efficiency of the fomentation. 



Two days after the accident the oozing of blood and serum, which had 

 been considerable during the previous twenty-four hours, had nearly ceased ; 

 but he still experienced comfort from the fomentation, though any pain which 

 he felt was connected with the simple fracture of the humerus. His pulse 

 was 88 ; his tongue clean and appetite good after a sound sleep at night ; and 

 from this time onward his general health continued perfectly satisfactory. 

 On the fourth day a small quantity of pale, grey, slimy discharge was observed 

 from beneath the crust at one part ; and thinking that this might, perhaps, 

 have occurred for want of proper action of the carbolic acid, I applied the latter 

 with unusual freedom to the surface of the crust. This was repeated at night ; 

 and the same energetic use of the carbolic acid, twice in the twenty-four hours, 

 was continued on the fifth day. Yet, on the sixth day, the discharge from 

 beneath the crust, instead of being diminished, was increased, and more puri- 

 form to the naked eye ; while, under the microscope, there was clear indication 

 of new cell-formation, whereas, on the day before, nothing but fibrinous material, 

 with granular and other debris, had been discoverable. On the seventh day 



