i86 CONTEMPORARY SCIENCE 



lacerated wounds, and especially bad bone smashes, 

 are so contaminated that it can never be possible to 

 render them aseptic. 



There is a noteworthy difference between the results 

 of the wounds in the case of the trench-inhabiting soldiers 

 and the wounds of sailors. The latter escape the dangers 

 of the soil-infected trenches. 



Sailors with the most severe type of wound, ragged, 

 irregular, with uneven surface produced by herniated 

 muscle and retracted severed fibers, usually have re- 

 covered promptly. Soldiers suffering from slight 

 wounds have often had them contaminated with bac- 

 illi from the soil ; particularly the anaerobes. 



Hypertonic salt solutions like sea water are actually 

 remedial by promoting the flow of lymph and serum in 

 the wounded tissues. 



But in a very large number of wounded soldiers, pos- 

 sibly the majority, hours and sometimes even days of 

 delay ensure infection and then the surgeon is face to face 

 with the one overwhelming surgical problem which has 

 so far baffled all our efforts, viz., how to transform a sep- 

 tic wound into an aseptic wound and keep it so, and at 

 the same time how to combat the toxins already diffused 

 throughout the body, but without doing harm to the pa- 

 tient himself. Cheyne, 22 Ehrlich, Wright and Carrel are 

 all at work and it may be that the happy day when this, 

 the most pressing and urgent problem in surgery, shall be 

 solved, may come through this devastating war. 23 



22 Lancet, Feb. 27, 1915, p. 419. 



23 In the British Medical Journal of April 10, 1915, a most im- 

 portant article by Sir Almoth E. Wright on "Wound Infections" 

 is begun. This should be very carefully read. On pp. 735-738 

 of the same Journal for April 24, 1915, is another very important 

 paper giving full directions for treatment. See also an interesting 

 editorial in the Journal American Medical Association, May 23, 

 1915, p. 1765. 



