26 ON A NEW METHOD OF TREATING 



about three inches long at the upper part of the left thigh, running transversely 

 from the middle of the inner side of the limb to its posterior aspect, and in this 

 wound the upper fragment of the femur was visible, somewhat displaced, but 

 not protruding. There was some bleeding, but not to any serious extent. He 

 sponged out the wound thoroughly with a solution of one part of carbolic acid 

 in three parts of olive oil, and then covered its lips with a mixture of blood 

 and the undiluted acid spread upon lint, and over this a piece of sheet-tin, 

 retained in position by means of a looped bandage. He next corrected the 

 faulty position of the fragments and applied lateral splints of Gooch's material 

 to the thigh, maintaining gentle extension by means of plasters applied to the 

 integument of the leg after the American plan, and fixed to the foot of the bed, 

 a perineal band being attached to the bed-head. While the left limb was thus 

 kept readily accessible for changing the dressings, the long splint was employed 

 as usual for the simple fracture on the right side. 



Next day the surface of the crust was touched with carbolic acid, and a hot 

 fomentation applied to the limb. 



On the third day the crust was removed through a misunderstanding, 

 but it was resolved to follow out the treatment on the same principle, and with 

 this view the wound was dressed twice a day with lint dipped in the mixture 

 of carbolic acid and oil (one part to three), covered with the tin, as the crust 

 had been before, while the fomentations also were continued. Meanwhile the 

 limb remained free from pain, redness, or swelling, and there was a complete 

 absence of constitutional disturbance. 



On the sixth day, however, he was a little feverish, and remained so, though 

 without any apparent local symptoms, till the twelfth day, when Mr. Thomson 

 noticed that the central part of the wound, which had become covered with 

 a whitish crust, was somewhat prominent, and, on careful examination, per- 

 ceived a distinct sense of fluctuation. He therefore removed the white layer 

 from that part, when eight ounces of perfectly odourless pus escaped. A probe 

 introduced failed to detect any bare bone. Mr. Thomson now sponged out 

 the cavity of the abscess with the mixture of carbolic acid and oil, and left in 

 it a strip of lint dipped in the same, continuing the other dressings as before. 

 The constitutional disturbance now at once subsided, and under the same dress- 

 ing the cavity of the abscess quickly contracted, and in a little more than a fort- 

 night closed entirely. Six weeks after the accident the wound was completely 

 healed, and both the thigh-bones were firmly united, with the limbs of equal 

 length. In another week he was able to stand. 



This case, which, I cannot avoid remarking, reflects great credit on the 

 house surgeon in charge, is interesting as another instance of the occurrence of 



