280 LORD LISTER 



while the limb was free from swelling or tenderness; a 

 although he had not attempted to exercise it much, the joint 

 could already be moved through a considerable angle. Here 

 the antiseptic principle had effected the restoration of a 

 joint, which, on any other known system of treatment, must 

 have been excised. 



Ordinary contused wounds are, of course, amenable to 

 the same treatment as compound fractures, which are a 

 complicated variety of them. I will content myself with 

 mentioning a single instance of this class of cases. In April 

 last, a volunteer was discharging a rifle when it burst, and 

 blew back the thumb with its metacarpal bone, so that it 

 could be bent back as on a hinge at the trapezial joint, which 

 had evidently been opened, while all the soft parts between 

 the metacarpal bones of the thumb and forefinger were 

 torn through. I need not insist before my present audience 

 on the ugly character of such an injury. My house-surgeon, 

 Mr. Hector Cameron, applied carbolic acid to the whole 

 raw surface, and completed the dressing as if for com- 

 pound fracture. The hand remained free from pain, red- 

 ness or swelling, and with the exception of a shallow groove, 

 all the wound consolidated without a drop of matter, so 

 that if it had been a clean cut, it would have been regarded 

 as a good example of primary union. The small granulating 

 surface soon healed, and at present a linear cicatrix alone 

 tells of the injury he has sustained, while his thumb has all 

 its movements and his hand a fine grasp. 



If the severest forms of contused and lacerated wounds 

 heal thus kindly under the antiseptic treatment, it is obvious 

 that its application to simple incised wounds must be merely 

 a matter of detail. I have devoted a good deal of attention 

 to this class, but I have not as yet pleased myself altogether 

 with any of the methods I have employed. I am, however, 

 prepared to go so far as to say that a solution of carbolic acid 

 in twenty parts of water, while a mild and cleanly application, 

 may be relied on for destroying any septic germs that may 

 fall upon the wound during the performance of an operation ; 

 and also that, for preventing the subsequent introduction 

 of others, the paste above described, applied as for com- 

 pound fractures, gives excellent results. Thus I have had a 







