890 
DEPARTMENT OF SURGERY. 
the purpose of cauterizing the tissue and thus form a clothing 
until nature itself puts up its own wall against infection. After 
a few days weaker solutions may be used. Spraying such 
wounds with kerosene oil, oil of turpentine, or pure creolin is 
also an effectual method of protecting them. Kerosene must 
not be belittled in this connection, for if sprayed carefully into 
a wound it will form just the very coating the surgeon desires 
and will then not blister the parts beneath. 
The Routine of Wound Treatment. 
1. Its examination. 
2. Removal of all foreign matter and tissues that will 
become necrotic, or are already dead. 
3. Its sterilization. 
4. Arrest of all haemorrhage. 
5. Suturing and draining. 
6. Protecting against infection during regeneration. 
1. Examination of a Wound .—Whether surgical or acci¬ 
dental a wound must be carefully examined before it can be in¬ 
telligently treated. The importance of drainage, the prerequisites 
of occlusive dressings and the dangers of septic diseases already 
enumerated should be a warning to the thoughtless and careless 
surgeon. The examination should determine the subsequent 
steps of the treatment. It is advisable first to make a careful 
inspection and if satisfied there are no hidden recesses, foreign 
matter or injured textures requiring special attention, no farther 
manual examination should be attempted, for in spite of our 
cleanliness the fingers are dangerous infection carriers; but 
when the eyes cannot inspect every recess palpation should not 
be omitted. Palpate with metallic probes, and then the fingers, 
if still in doubt, but never with the fingers until other methods 
have been exhausted. 
As already stated the examination enables 11s to outline 
intelligent treatment. We determine whether or not there are 
foreign bodies to be removed, whether this or that shred has 
sufficient blood supply to warrant its preservation and retention 
in the wound, we note every recess that will require sterilizing, 
we observe the source of the haemorrhage and decide upon 
methods to control it, we decide upon what form of suturing is 
indicated and devise means for drainage, and finally we deter¬ 
mine what form of protection will be most effectual. So there¬ 
fore w r e see that the examination of a W'Ound like the diagnosis 
of internal lesions is essential in order to apply rational therapy. 
(To be continued. ) 
