54 ANTISEPTIC TREATMENT OF WOUNDS. 
fection of infected wounds will be given the deserved atten- 
tion here. 
The disinfection of a wound consists in making innocuous 
all pathogenic germs that have entered into it and are living 
there. We have the following ways to do that: 
First—Removal of the microbes. 
Second—Killing of the microbes. 
(a) Through chemical means, which directly kill the mi- 
crobes. 
(b) By changing the substratum so that the microbes can- 
not find a suitable condition for vitality, and hence, die. 
If we have to treat a simple three or four-day-old wound of 
the soft parts with smooth walls, a thorough rinsing out with 
a I per cent. sublimate or 5 per cent. carbolic solution is 
suificient to disinfect it. This simple rinsing, however, does not 
suffice if we have a granulating wound or one with sinuses, or a 
contused wound. In such cases the conditions favoring the. 
settlement of micro organisms must be first removed, and 
for this purpose the cutting instruments only are useful. It 
is best to scrape off the granulating surfaces with the sharp 
scoop, cut off with the scissors or knife all shreds of tissue, 
which cleave to the fissures, even up the edges of the wound, 
remove all foreign bodies, or, in a word, change the fissured 
wound, with the aid of the surgical instruments, into as 
smooth a one as possible. With this dressing of the wound, 
especially with the sharp scoop, a large portion of the mi- 
crobes present in the wound are removed, and we disinfect in 
this manner. Only after the coarsest portion of the disinfec- 
tion has thus been mechanically performed, do we use, as in a 
simple wound, the disinfecting fluids to irrigate it. 
Occasionally it happens, owing to larger surface hemor- 
rhages, especially in cavity or socket wounds, that we are 
prevented from proceeding in the above manner. In such 
cases the use of heat is recommended to attain a sufficient 
disinfection. For this purpose PAQUELIN’S Thermo-Cau- 
tery is to be recommended, because with it we can con- 
veniently disinfect larger surfaces by simply searing’ them 
