DISEASES FROM SEPTIC INFECTION OF WOUNDS. 313 



holes cut in them. These are placed in the deepest part of the 

 wound, and fastened by a stitch in the skin, or the wound closed 

 around it. In small wounds use instead small pieces of silk thread 

 or catgut, twisted together in the shape of a cord. Wounds which 

 are not deep, but cavernous, and where it is difficult to get quick 

 adhesion, in order to insure proper drainage, it is best to leave 

 the wound open, covered with antiseptic powder, such as sul- 

 phonal, boric acid, naphthalin, salicj'lic acid, compound tinc- 

 ture of benzoin, etc. The first-named agents possess special proper- 

 ties for the treatment of surgical wounds, drying them rapidly and 

 depriving the microbes of a proper medium to develop in, and 

 thus rendering it impossible for them to extend. 



It is advisable to use some material that will take up the secre- 

 tions of the wound quickly, and assist in drying them. For this 

 purpose, we use boric acid, salicylic-, or carbolic-acid gauze. Cover 

 the wound with the gauze, and in wounds with cavities fill them 

 with a tampon of the same material. In some wounds where 

 there is a deep cavity fill the wound with a tampon of fine Carbolic 

 Acid, allow it to remain five minutes; by means of sutures bring 

 it together and cover it with iodoform-gauze. 



The following is the ordinary treatment of Wounds : 



(1) Controlling the Hemorrhage. This may be accomplished in 

 various ways. The best method is by means of a ligature. As a 

 rule, this is performed by carefully ligating the bleeding blood- 

 vessel, either directly on the veiu or artery, or taking up a certain 

 portion of the tissue vyith a pair of forceps, including the blood- 

 vessels, and tying it behind the point of the instrument with catgut 

 or silk. When the bleeding end of a bloodvessel i.s located in 

 very firm tissue, out of which it cannot be drawn far enough to 

 ligate, we pick up the bloodv^essel with the end of the forceps, 

 draw it out as far as possible, and twist it in a spiral direction; 

 by this means we usually succeed in controlling the hemorrhage. 

 If, however, the above does not answer, we pass a thread through 

 the tissue underneath the bloodvessel and tie it tightly, and by 

 this means close the opening. 



Compression is sometimes used as a means of stopping hemor- 

 rhage. This we can accomplish by pressure of the finger above 

 the bleeding region, or, if it is an extremity, ligate the member 



