OF TREATMENT IX SURGERY 8i 



rapidly till, by the eleventh day, the calf was almost of natural size, having 

 shrunk away considerably from the splint. His pulse never rose above 82, 

 which was its number the day after the accident, and his general health was 

 from that time forward quite unaffected. 



Ten days after the receipt of the injury, it was noticed that the oily cloth, 

 which for a week past had indicated complete absence of discharge, exhibited 

 an appearance of additional staining, corresponding to two or three drops of 

 red serum which seemed to have been pent up beneath the lac-plaster b\' in- 

 spissation of the blood and serum round its margins, till some accidental cause, 

 such as the shrinking of the limb, cracked the dried exudation. Having been 

 led to disturb the dressing to some extent in investigating the source of this 

 discharge, I thought it best to remove it entirely, protecting the wound at the 

 moment of its exposure with a bit of antiseptic lint. The under surface of the 

 lac gave distinct indications of being impregnated with carbolic acid. The 

 wound presented a very interesting appearance. It had shrunk considerably ; 

 but its margins resembled those of a perfectly recent wound ; and its orifice 

 was occupied by a projecting dark clot, which to the naked eye scarcely differed 

 from a fresh coagulum. Hence there seemed reason still to hope for healing 

 without suppuration, if the original mode of dressing were repeated. Accord- 

 ingly, the tin smeared with carbolic acid was replaced, and overlapping it a fresh 

 portion of lac-plaster, rendered adhesive by touching it with carbolic acid after 

 removing the film of gutta-percha, except in a narrow space from the centre 

 to one side, where the gutta-percha was left, to provide for the escape of dis- 

 charge. A dry cloth and the splint completed the dressing. Two days later, 

 in order to maintain the lac- plaster in an antiseptic condition, two layers of 

 calico, moistened with a solution of carbolic acid in four parts of olive oil, were 

 substituted for the cloth ; and afterwards, at intervals of from two to three 

 days, the surface of the calico was lightly brushed over with a mixture of equal 

 parts of the oil and acid. For six days, some yellowish serum, amounting at 

 first to one or two minims in twenty-four hours, but gradually diminishing, 

 exuded from below that part of the margin of the lac-plaster where the gutta- 

 percha film had been left, the amount being estimated by changing every day 

 a little bit of antiseptic lint placed at the point of exudation. But, after the 

 sixth day, the piece of lint was left unchanged, as the trifling discharge seemed 

 to have ceased entirely. When eleven days more had passed without any change, 

 I thought it well to ascertain again the state of the wound ; and on the 30th of 

 October, seventeen days after the second application of the deep dressing, and 

 two days short of four weeks after the accident, I pulled off the lac-plaster with 

 the tin adhering to it. 'Vhv plaster was still sticking to the skin, and drew 



LISTER II G 



