76 WOUNDS AND BRUISES. 



by an ordinarv^ drainage tube, or, as suggested by Major Blen- 

 kinsop, A.V.D., by using a cord of six or seven long horsehairs which 

 have been soaked for say half an hour in a 1 to 20 solution of 

 carbolic acid in water. This cord may be passed through the wound 

 as a seton, 



APPEAEANCE OF WOUNDS.— We may assume that a wound is 

 healthy when it looks like a clean cut, or, as if a piece had been 

 cleanly punched out of the flesh; unhealthy, when it is pale, and 

 covered with pus, or small clots, and with large, soft granulations; 

 inflamed or angry, when it is of a dark red colour with a good deal 

 of lieat ; and indolent, when the process of repair appears arrested, 

 as in a "sit-fast" (p. 102). 



GENERAL REMARKS. — Unhealthy and indolent sores and 

 abscesses are best treated, by, in the first instance, scraping away 

 the pus-forming substance (granulating tissue) which covers or 

 lines them. A Volkmann's spoon is an admirable instrument for 

 performing this necessary operation, after which, the free use of 

 turpentine (p. 68) or other suitable antiseptic would be advisable ; 

 or with an indolent sore, we might apply a hot iron over its 

 surface, especially w^hen its sides have become hardened, and have, 

 to a certain extent, lost their vitality, as in old abscesses. When 

 tlio wound is the seat of some noxious growth, as in " bursatee " 

 (p. 145), we should render it healthy by the free use of the knife. 



Inflamed wounds should be treated by continued bathing in, or 

 with, warm water, or by poultices, so as to relieve the unusual 

 tension, soothe the irritation, and hasten the process of repair by 

 granulation. In all cases it is well to mix an antiseptic (p. 67) 

 through a poultice; for, if this is not done, the poultice will tend 

 to prevent repair by encouraging the growth of bacteria. 



Punctured wounds are the most dangerous variety; as the undue 

 retention of their contents is apt to give rise to serious inflammation, 

 and to grave constitutional disturbance, from the absorption of pu- 

 trid material. We may place under this heading, deep-seated wounds 

 caused by the opening of an abscess. As a rule, the contents of such 

 wounds should be syringed out three or four times a day, which may 

 be done at first with lukewarm water, and afterwards with a weak 

 antiseptic sohition (p. 67). For this purpose, I have found Read's 

 clyster pump veiy useful. It is well to have a thin bone pipe 

 (somewhat similar to that of an ear-syringe and about 4 inches 

 lon^) ready for use, in case the usual enema tube is too large. The 

 drainage of these wounds should be carefully attended to. As it 

 is very difficult to do this effectually when these wounds are deep, 

 Ave can rarely hope that they will then, especially when caused by 



