364 



ON THE ANTISEPTIC MANAGEMENT OF WOUNDS 



with something rehably antiseptic before we wash surrounding impure parts, 

 so as to avoid the chance of defihng the wound with them. For these washings 

 we use the i to 40 carbohc lotion. iVs to the times for changing the dressings, 

 it is no doubt true that that which is apphed immediately after the operation 

 might in most cases be left untouched for several days. Nevertheless, when 

 discharge is free, I prefer, as a rule, to remove the first dressing when the first 

 twenty-four hours have passed. We thus get rid of the serum and corpuscles, 

 which, while they constitute the largest amount of discharge which occurs in 

 the case, test, as we have seen, our antiseptic dressings the most severely. The 

 discharge being still moist near the wound at this period, the gauze is lifted 

 from it without disturbing it in the slightest degree ; and I never knew a patient 

 fail to express himself as feeling more comfortable when the first dressing had 

 been changed. There are, however, special cases, like a stump after amputation 

 of the thigh, where an exception may be made on account of the disturbance of 

 the wound that the changing of the dressing would involve. 



In conclusion, I may remark that it pleases me, as the years pass, to see 

 the hope which I expressed at the International Congress in London eleven years 

 ago in course of fulfilment, namely, that the use of the antiseptic system would 

 gradually spread by leavening action throughout the world. At the same time, 

 I am sorry sometimes to observe that unnecessary trouble is often taken in some 

 directions while essential points are disregarded in others ; so that, with the 

 best intentions, the best results are not always obtained. I venture to hope 

 that this address may be of some use to you in directing your attention to the 

 essential conditions of success. 



ii 



