44 ON THE ANTISEPTIC PRINCIPLE 



by the incision. On applying a probe guarded with an antiseptic rag, I found 

 that the sinus was soundly closed, while the limb was free from swelling or 

 tenderness ; and, although he had not attempted to exercise it much, the joint 

 could already be moved through a considerable angle. Here the antiseptic 

 principle had effected the restoration of a joint which on any other known 

 system of treatment must have been excised. 



Ordinar}^ contused wounds are of course amenable to the same treatment 

 as compound fractures, which are a complicated variety of them. I will content 

 myself with mentioning a single instance of this class of cases. In April last 

 a volunteer was discharging a rifle, when it burst, and blew back the thumb 

 with its metacarpal bone, so that it could be bent back as on a hinge at the 

 trapezial joint, which had evidentty been opened, while all the soft parts between 

 the metacarpal bones of the thumb and fore-finger were torn through. I need 

 not insist before my present audience on the ugly character of such an injury. 

 My house surgeon, Mr. Hector Cameron, applied carbolic acid to the whole raw 

 surface, and completed the dressing as if for compound fracture. The hand 

 remained free from pain, redness, or swelling, and, with the exception of a shallow 

 groove, all the wound consolidated without a drop of matter, so that if it had 

 been a clean cut, it would have been regarded as a good example of primary 

 union. The small granulating surface soon healed, and at present a linear 

 cicatrix alone tells of the injury he had sustained, while his thumb has all its 

 movements and his hand a firm grasp. 



If the severest forms of contused and lacerated wounds heal thus kindly 

 under the antiseptic treatment, it is obvious that its application to simple incised 

 wounds must be merely a matter of detail. I have devoted a good deal of 

 attention to this class, but I have not as yet pleased myself altogether with 

 any of the methods I have employed. I am, however, prepared to go so far 

 as to say that a solution of carbolic acid in twenty parts of water, while a mild 

 and cleanly application, may be relied on for destroying any septic germs that 

 may fall upon the wound during the performance of an operation ; and also 

 that for preventing the subsequent introduction of others, the paste above 

 described, applied as for compound fractures, gives excellent results. Thus 

 I have had a case of strangulated inguinal hernia, in which it was necessary to 

 take away half a pound of thickened omentum, heal without any deep-seated 

 suppuration or any tenderness of the sac or any fever ; and amputations, in- 

 cluding one immediately below the knee, have remained absolutely free from 

 constitutional symptoms. 



Further, I have found that when the antiseptic treatment is efficiently 

 conducted, ligatures may be safely cut short and left to be disposed of by 



