TREATMENT OP WOUNDS 121 



made to deposit a hose, small enough to allow reflux, 

 back to the very bottom of the tract, and then with a 

 fountain syringe or hydrant irrigate the tract for sev- 

 eral hours. Pure water, physiological saline solution, or 

 a weak antiseptic should be used. A perfunctory treat- 

 ment of this kind will not do much good, but a prolonged, 

 carefully done irrigation may perfectly sterilize such a 

 wound. 



The following ease serves to illustrate : A horse 'sus- 

 tained a puncture by a broken shaft of a single wagon, 

 extending from the breast to the level of the olecranon. 

 Having determined the location of the bottom with a 

 long sound, a counter-opening was made through the 

 skin behind the^ elbow. A hydrant hose was placed in 

 the counter-opening and a good stream was turned on 

 for four hours. Besides peppering the two wounds with 

 an antiseptic powder several times a day, no other treat- 

 ment was given after this one irrigation. In spite of the 

 great dimensions of this wound there was never any sup- 

 puration and the patient returned to work in exactly 

 three weeks, entirely healed up. The success here was 

 due to the perfect sterilization by the long irrigation. 

 Whenever such irrigations are attempted, provisions must 

 always be made for a free reflux of the water by using 

 a hose of smaller caliber than the tract, otherwise in- 

 fected material might be driven into the tissue spaces far 

 beyond the original wound. 



For smaller punctured wounds that can not easily be 

 mechanically disinfected, a loose antiseptic wick should 

 be inserted along the whole tract and changed fre- 

 quently. This may be preceded by injections of hydro- 

 gen peroxide. 



Finally, a dose of antitetanic serum is given in all 

 punctured wounds to prevent tetanus. The dose should 

 Vary from 500 to 1,500 units, according to time of ad- 



