28 ON A NEW METHOD OF TREATING 



day, when the fomentations were discontinued, and. the edges of the crust 

 which were loose were chpped away, and Hnt moistened with water was appHed 

 to the granulating surface thus exposed, the remainder of the crust being still 

 touched daily with carbolic acid. Meanwhile there had been no suppuration 

 beneath the crust, and the patient had remained free from constitutional 

 symptoms. 



On the seventeenth day the crust, which had separated from the wound 

 at its lower third, was removed, disclosing a healthy granulating surface, the 

 bone being nowhere visible, while there was no appearance of pus, except a 

 trifling amount towards the lower part. The sore, which was entirely super- 

 ficial, was now treated like an ordinary ulcer, and healed quickly. The bone 

 also united as in a simple fracture, and he was discharged eight weeks after the 

 receipt of the injury, having been kept longer in the hospital than would other- 

 wise have been necessary, on account of a head affection to which he was subject. 



The above case, besides being a good example of the effects of the treat- 

 ment of compound fracture with carbolic acid, affords an illustration of a practice 

 which I have on several occasions found useful when there has been but little 

 bleeding from the wound, a dough or paste composed of flour or starch, mois- 

 tened with the acid, being employed in lieu of the compound with blood to 

 render the crust sufficiently substantial. 



Case io. — Thomas M'B , a labourer, who gave his age as fifty-two, 



but had the appearance of a much older person, was admitted at noon on the 

 2nd of January, 1867, under the care of Dr. G. Buchanan, having been knocked 

 down an hour before by the shaft of a luggage wagon, the wheel of which passed 

 over his left leg, producing a compound fracture in the lower third of the limb. 

 Mr. James Robinson, the house surgeon, who has given me notes of the case, 

 found a wound from which blood was oozing, about an inch and a half in length, 

 exposing part of the tibia, and communicating with the seat of fracture. The 

 tissues were pretty severely contused. Undiluted carbolic acid was applied 

 freely to the interior of the wound by means of lint held in a pair of dressing- 

 forceps, and a crust was formed of blood mingled with the acid, covered with 

 lint, over which a cap of tin was placed, well bulged out to correspond to the 

 substantial crust, and large enough to overlap to a slight extent the sound skin 

 in the vicinity. The fragments having been brought into proper position, the 

 limb was put up with lateral wooden splints, with a hot fomentation. At the 

 conclusion of the dressing the patient expressed himself as greatly relieved. 

 The pulse was then 65. 



Next day he was free from pain after a fair night's rest. The pulse was 74, 



