76 WOUNDS AND BRUISES. 



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. 



APPEARANCE OF WOUNDS.— It may- be assumed 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 heat ; 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, in the first instance, by 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. 

 With an indolent sore, a hot iron may be applied over its surface, 

 especially when its sides have become hardened, and have, to a 

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

 wound is the seat of some noxious growth, as in " bursatee " (p. 

 145), it should be rendered 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; 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 inflamma- 

 tion, and grave constitutional distiirbance, from the absorption of 

 putrid material. Deep-seated wounds caused by the opening of an 

 abscess may be placed under this heading. As a rule, the 

 contents of such wounds should be syringed out three or four 

 times a day; this may be done at first with lukewarm water, and 

 afterwards with a weak antiseptic solution (p. 67). Read's clyster 

 pump is very useful for this purpose. It is well to have a thin 

 bone pipe (somewhat similar to that of an ear-syringe and about 

 4 inches long) ready for use, in case the usual enema tube is too 

 large. The drainage of these wounds should be carefully attended 

 to. It is very difficult to do this effectually when these wounds 

 are deep, and then, especially when caused by an accident, they 

 rarely heal, except by granulation. Hence in these cases, if 



