98 WOUND TEEATMENT 



usually patched up with, needle and thread after a per- 

 functory ablution with an antiseptic solution. Pour days 

 later it is an. open wound again, more seriously and more 

 deeply infected than if it had been left entirely to the 

 mercies of nature. To change thi^ Order of affairs is now 

 our serious duty, and in view of the fact that it is exceed- 

 ingly easy to show the difference between good wound 

 treatment and poor wound treatment the objection to put- 

 ting a stiff initial cost on the treatment of stich a wound 

 will not be long lived. We have done it in a city prac- 

 tice and I am sure the country practitioner can do 

 likewise. 



Formerly we treated accidental wounds of all kinds, 

 except enormous ones, in the stables. We secured the 

 patient with the twitch and sideline, washed the wound, 

 sewed it up after more or less of a running fight with 

 the patient, and then applied whatever protection best 

 suited, in the usual four or five days we were always 

 called again to do the work over. "The stitches have 

 broken out," was the usual cry. Sometimes a second at- 

 tempt at closure was made, but more often the dangling 

 skin was trimmed and open-wound treatment applied 

 during the remaining long process of cicatrization. In 

 such cases there was the cost of the first treatment ; of a 

 number of periodical visits during the succeeding six 

 weeks ; of antiseptic lotions, astringent lotions, and pow- 

 ders, without accounting for the costly days of disability. 



To-day we bring such patients to the hospital, devote 

 two or three hours to the initial treatment, keep tha 

 patient in the hospital eight days, and usually return it 

 to work at the end of two weeks, or in three in cases of 

 extensive wounds. In the former cases the scar waS large, 

 indelible, conspicuous; in the latter there is often no 

 plain evidence that a wound has ever existed. The cost 

 to the client is about the same in both cases, but in the 



