TREATMENT OP INJURED HAND 168 



offensive; if, however, there be necrosis, decom- 

 position of the discharges or maceration of callo- 

 sities or scabs, there is a very pronounced and dis- 

 agreeable odor of putrefaction. I have noticed in 

 wounds in syphilitics a characteristic odor, also in 

 those made by ice-cutting tools, and in human 

 bites. Wounds infected with glanders or diph- 

 theria present the peculiar odors of those diseases. 

 All these things the experienced surgeon bearg in 

 mind. 



Macroscopic inspection of wounds will reveal 

 much concerning their extent and condition, but 

 the eye must be supported by the touch, as there 

 are many things in an injury which the eye cannot 

 detect and many appearances which are highly de- 

 ceptive. In cases where there is doubt as to the 

 nature of infection resort is had to bacteriologic 

 culture and miscroscopic examinations. 



A most important adjunct to the ocular exami- 

 nation of injuries is the x-ray apparatus whereby 

 fractures, dislocations, bone inflammations and 

 necrosis can be definitely determined and metallic 

 bodies located. 



