50 THE ANTISEPTIC SYSTEM OF TREATMENT IN SURGERY 



But although suppuration resulting from the stimulating influence of the 

 antiseptic is no cause for anxiety, it is more convenient that it should be avoided; 

 and this may often be done entirely by leaving the lower layers of the dressing 

 permanently on the limb and changing only its superficial parts — a plan which, 

 while it protects the wound against the introduction of mischievous particles, 

 permits the foreign body in contact with the tissues to part with its antiseptic 

 material and become an unstimulating crust, under which complete healing by 

 scabbing may occur in wounds of a size hitherto regarded as inconsistent with 

 this process in the human subject. 



Upon these principles a really trustworthy treatment for compound frac- 

 tures and other severe contused wounds has been established for the first time, 

 so far as I am aware, in the history of surgery. In a hospital which receives 

 an unusually large number of patients suffering from machinery accidents, 

 and in wards which, from circumstances to which I need not here allude, were 

 peculiarly unhealthy, my experience of compound fracture in the lower limb 

 was formerly far indeed from satisfactory, even in the selected cases in which 

 alone I attempted to save the limb. But since the antiseptic principle has 

 guided us, not only have ordinary cases of this formidable injury been treated 

 by my successive house surgeons with unvarying success, but limbs such as 

 I should once have condemned without hesitation have gone on to complete 

 recovery without either local or constitutional disturbance : a statement which 

 might be suspected of exaggeration were it not that it refers to proceedings 

 in a public hospital, witnessed not only by students, but by gentlemen once 

 my pupils, and now practitioners in Glasgow. 



In the next article I propose, after a few words regarding the principles 

 applicable to simple incised wounds, to describe in detail the methods of pro- 

 cedure, illustrated by cases. 



