COMPOUND FRACTURE, ABSCESS, ETC. 13 



to the leg and foot, and strengthened by a temporary wooden sphnt. A porous 

 cloth was applied over the tin to absorb the blood and serum which must escape 

 from beneath its edges ; and the whole apparatus was secured with a roller. 

 At the conclusion of the dressing the pulse was 112. 



He passed a restless night, though occasionally dozing, and the pulse next 

 morning was 120. The bandage having been cut away sufficiently to enable the 

 tin to be removed, the wound was found to have gaped so that the lint no longer 

 covered the whole of it. Pieces of the cloth, which had become soaked with the 

 exuded blood, were placed upon the exposed part, and also over the lint so as 

 to make the crust more substantial, and the whole was freelv treated with 

 carbolic acid. The tin was then bulged out so as to be accommodated to the 

 thickened crust, while overlapping the neighbouring skin to a slight extent ; 

 being retained in position by a couple of turns of bandage. A hot fomentation 

 was then placed upon the inner aspect of the limb, and the whole leg enveloped 

 in a large sheet of block-tin secured by looped bandages. 



In the evening the pulse was 136, and on the following morning, thirty-six 

 hours after the accident, it had risen to 168, and was very weak. He lay talking 

 to himself in a rambling manner, unable to understand what was said to him. 

 He was extremely restless, and had taken no food whatever since his admission. 

 During the next night, however, he became composed, and took a little milk ; 

 and on the morning of the third day he was found to be again intelligent, while 

 the pulse had fallen to 140, and was of fair strength. The skin in the vicinit}- 

 of the injur}', both at the knee and ankle, was free from discoloration or 

 swelling ; but part of the large flap of skin over the calf was of purple tint, and 

 had evidently lost its vitality. This dead part was touched with carbolic acid, 

 to preserve it from decomposition, and convert it into a crust for the protection 

 of the subjacent textures, and an additional piece of tin was applied to cover it. 

 A good deal of brown transparent fluid escaped from beneath the crust. 



On the fourth day the pulse was 120 ; he was quite bright and tranquil, 

 and said he felt no pain. There was still no odour about the injured part, 

 except that of carbolic acid. The discharge was much diminished, and was 

 principally serous. 



By the sixth day the pulse was as low as 108. He had a heart}- appetite, 

 and also took with avidity the six ounces of port wine allowed him during the 

 twenty-four hours. His tongue, which had previously been dr\-. was moist. 

 He had slept well at night, though waking occasionally with a scream. The 

 discharge from beneath the crust, trilling in amount, was chiell}' serous. 



On the eighth day the s])lint was removed for the first time, and was co\'ered 

 with sheet-tin in order to prevent the discharge from softening the pasteboard. 



