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SURGICAL ANTISEPSIS AND ASEPSIS. 47 
only tried to reduce to the minimum the secretions and prevent acci- 
dents from infections. Hemostasis insured, he washed the wound 
with tepid water, then with a mixture of water and camphorated 
alcohol; in some cases he saturated the wound with it, cut the 
threads of the sutures close to the skin, and then covered the whole 
with several layers of wadding. In serious operations upon the ex- 
tremities, those were wrapped up in sheets of wadding superposed 
in such a way that the leg seemed to be three times its ordinary size. 
The wadding was then fixed tight with linen bands properly applied ; 
the whole of it was to be sufficiently pressed to give on percussion 
‘a resonance resembling that of the normal thoracic cavity.” If, on 
the following days, the degree of pressure proved insufficient, new 
bands were applied, and if the dressing appeared to be run through 
by the serosity of the wound, other layers of wadding were applied 
over it. This dressing was first left in place for 20 or 25 days; 
later, it was changed after 12 or 15 days. Generally, when the first 
dressing was taken off, the wound was granulating throughout its 
whole extent. After a second dressing, having been left 8 or 10 
days, often cicatrization was complete. 
Several modifications of this method have been introduced which 
permitted reunion by the first intention. First, the hemostasis was 
made more vigorous and the edges of the wound were fixed together 
with absorbable thread (catgut) placed more or less deeply. Besides 
its numerous advantages, the wadding-dressing had the disadvan- 
tage of concealing from the surgeon the condition of the trauma- 
tism. Itis true the thermometric observations informed him of the 
complications likely to occur; but as it sometimes happens that 
thermometric elevations show themselves in the case of patients 
whose wounds are doing well, much time was lost, and patients 
were exposed to complications by uncovering wounds in process of 
cicatrization. And again, although in protecting the wounds by 
layers of wadding atmospheric germs were prevented from reach- 
ing the divided tissues, those which had already been deposited on 
them during the operation were not destroyed; and these, though 
under restraint (mal 4 Vase), were nevertheless multiplying, often 
with great rapidity. 
Still, compared with the old dressings, the wadded apparatus was 
an immense advance in the surgicalart. It was employed, how- 
ever, but little; and was. obliged to make room for the Listerian. 
_ dressing, more practical and more trustworthy in its results. 
To prevent the infection of the wound, Lister strived to surround 
it with an atmosphere. freed from infectious elements and to destroy 
the germs of the surrounding aerial layer, those deposited on the sur- 
face of the wound, on the hands of the surgeon and his assistants, 
upon the instruments, the sponges, the compresses, and all objects 
