COMPOUND FRACTURE, ABSCESS, ETC. ii 



the discharge was still greater in amount ; yet the limb remained free from 

 pain, and was steadily diminishing in circumference, and pressure in the neigh- 

 bourhood of the crust failed to induce any increase of the discharge, which 

 appeared to be merely superficial. 



In the course of the next few da3^s it became apparent that this discharge, 

 so far from being the result of insufficient action of the carbolic acid, was caused 

 by the stimulating influence of the acid itself, apphed with greater freedom 

 over a crust much thinner than that of Case 3. Suppuration from this cause 

 is, however, productive of no mischief, as will be better understood from the 

 sequel. That such was the case in this instance was manifest on the fourteenth 

 day, when the crust, which was nearly detached, was removed, disclosing an 

 appearance for which I confess I had not been prepared. In place of the deep 

 and ragged wound was a granulating sore, nearh- on a level with the skin, and 

 pretty uniform in surface, except at one part about its middle, where there was 

 a depression about half an inch in depth, at the bottom of which a small portion 

 of the outer surface of the ulna was visible, bare, but of pink colour. Xot only 

 had the compound of blood and carbohc acid which had existed in the depths 

 of the wound been organized, but the portions of tissue killed by the violence 

 to which they had been subjected in the accident, and also those destroyed 

 by the caustic action of the carbohc acid, had been similarty acted on, and all 

 had been, so to speak, fused together into a living mass, without the occurrence 

 of any deep-seated suppuration. 



By the nineteenth day the exposed part of the bone was covered, and the 

 depression in the sore obhterated by granulation, without any exfoliation 

 occurring ; and two days short of seven weeks after the accident the sore was 

 entirely healed. 



The extensive loss both of bone and of the soft parts made osseous union 

 of the ulna a matter of difiiculty, and on the 5th of August the limb was placed 

 in a starched apparatus, to promote complete consolidation, and he was soon 

 after discharged from the hospital. 



About six weeks later he presented himself at the infirmar\-, and the bandage 

 was removed in my absence, when, the bone appearing firm, he was allowed 

 to dispense with the apparatus, and was unfortunately not directed to show 

 himself again. In the course of a few weeks, however, he appeared with tlie 

 fragments again movable. The starched bandage was therefore reapplied, but 

 when I last saw him, some weeks ago, bony union had not yet occurred. A 

 good deal of osseous formation had, however, taken place, so that the fragments 

 now overlapped each other ; and should the cure be still incomplete when he 

 next shows himself, the case will be a fair subject for Bickersteth's method of 



