82 ON THE ANTISEPTIC SYSTEM 



away the hairs along with it, except where the gutta-percha film remained. 

 At this part, along the course of the track of exudation, the skin had an orange 

 stain, from serum mixed with altered haematin, and was moist, except near 

 the edge of the plaster. Beneath the tin, also, there was the same kind of 

 orange moisture. The wound appeared at first sight unhealed, having an orange - 

 red aspect ; but, on wiping it with a piece of lint, a perfect cicatrix was disclosed, 

 which had been covered with the remains of the little portion of clot seen pro- 

 jecting from the orifice on the former occasion of exposing it. A piece of dry 

 lint was placed upon the scar ; and the splints were readjusted, the fragments 

 being in good position. The case was now reduced to one of simple fracture. 



This case presents several features of great interest. In the first place, 

 the appearances disclosed on the removal of the dressings on the tenth day 

 after the accident afford as good an illustration as could be desired of the fact 

 that the surface of a wound is not induced to suppurate, or indeed to undergo 

 any appreciable change by the contact of a foreign body, destitute of chemically 

 stimulating properties. The carbolic acid with which the surface of the tin 

 was washed, like that injected into the wound, was absorbed into the circulation 

 before it had time to bring about those changes in the part which are the essential 

 preliminary to suppuration. The tissues of a recent wound are incapable of 

 forming pus, however much they may be stimulated, whether by nervous (i.e. 

 inflammatory) excitement, or by chemical irritants, such as the products of 

 putrefaction or pungent antiseptics. It is only when they have been gradually 

 changed under the influence of prolonged abnormal stimulation into that rudi- 

 mentary form of tissue which, when we see it on the surface of a sore, we term 

 granulations, that they are liable to produce, when still further stimulated, 

 the still more rudimentary pus corpuscle. It is upon this that the possibility 

 of obtaining primary union on the antiseptic system depends. The antiseptic 

 applied to the wound in the first instance is a powerful stimulant, but it is 

 absorbed before it has time to bring about granulation in the tissues. 



In the second place, it is very satisfactory to see, although theoretically 

 it could hardly have been doubted, that, when a wound has been effectually 

 protected from stimulation and consequent granulation, it may, even at a late 

 period after its infliction, be again subjected to the temporary stimulus of an 

 antiseptic application without being made to suppurate ; for a knowledge of 

 this fact will enable us to examine the wound when we think there is a fair 

 prospect of healing being complete, confident that, should the reverse prove 

 to be the case, we can again employ the original mode of dressing without inter- 

 fering with the process of healing by scabbing. 



Thirdly, I may remark that cicatrization without suppuration beneath 



