244 ON RECENT IMPROVEMENTS IN THE 



opacity of epidermis when it sprang from the edges of the skin, but possessing 

 the dehcacy of the epitheUum of the interior of the hp and nostril when, the 

 skin of those parts having been all removed, cicatrization proceeded from the 

 margin of the mucous membrane. Ultimately there was about one inch in 

 breadth of the lower portion of the scar which presented these peculiar characters; 

 and the mucous cicatrix would doubtless have been more extensive had I not 

 supplied centres of epidermic growth over the general surface of the sore by 

 skin-grafting. 



The mode in which this was done deserves a moment's notice. As cicatriza- 

 tion was proceeding so satisfactorily under the boracic ointment, I thought 

 this application might perhaps prove not inconsistent with the preservation of 

 the vitality of skin grafts, so that the advantage of the procedure might be 

 obtained without putrefaction occurring in the sore, as would be the case if 

 the surface were covered with protective. I accordingly conducted the little 

 operation in the manner that has been described in an earlier part of this paper, 

 except that as each graft was laid down I placed upon it a morsel of the fine 

 rag spread with the ointment, a general piece being afterwards applied over all 

 to cover in the whole sore. But, to my disappointment, it turned out that not 

 a single graft took. The ointment, though so mild in its action as not to prevent 

 cell growth from epithelium which retained its connexions with its living neigh- 

 bours, was yet too strong for the portions of epidermis which were weakened 

 by isolation, and, before they had time to unite with the granulating surface, 

 operated upon them as an irritant or as a caustic. I therefore repeated the 

 process with this difference, that each graft, when placed upon the sore, was 

 covered with a very small square of the oiled silk protective dipped in boracic 

 lotion, and over this a rather larger square of the fine cloth spread with the 

 ointment, a large piece being afterwards applied to cover the whole. Thus each 

 graft was protected from the direct action of the boracic acid in the ointment, 

 while the bits of protective were everywhere so overlapped by the antiseptic 

 layer as to prevent putrefaction from entering. The result of this procedure 

 was that every one of the numerous grafts adhered, and the healing of the sore 

 proceeded to its completion with much greater rapidity, and I believe with 

 much less contraction of the scar, than would otherwise have been the case. 



In plastic operations such as those for the repair of the lower lip, the deeper 

 edges of the wound communicating with the buccal cavity with its septic contents, 

 any sort of antiseptic treatment may at first sight seem altogether out of place. 

 But the primary union between the cut surfaces, which may be reckoned on 

 almost as a matter of certainty if the operation has been so conducted that the 

 edges of the wound can be brought together without tension, prevents the 



