206 
HINTS TO TRAVELLERS. 
TREATMENT OF WOUNDS AND INJURIES. 
In treating wounds, whether large or small, the great essential is 
absolute cleanliness, not simple cleanliness in the ordinary acceptance of 
the word, but absolute surgical cleanliness. 
In the first place, it is as well to lay down the axiom that all inflamma¬ 
tion and other complications of wounds, as suppuration and blood- 
poisoning, are due to germs, and germs alone. All cleansing operations 
and antiseptic processes are instituted with the sole idea of preventing 
the entrance of germs into the wound, either from the hands of the 
operator, the dressings, instruments, or the skin of the patient. 
Antiseptics are chemical substances which have the power of killing 
germs outright, or so checking their growth that the cells in the blood 
can easily cope with them. The antiseptics that are mentioned in these 
notes are carbolic acid, chinosol, permanganate of potash, and boric acid. 
Given the antiseptic properties of the substance, it seems a simple 
thing, by its application, to prevent germs either entering a wound or 
multiplying there, but in actual practice the germ-free cleanliness of a 
wound is a difficult thing to procure. The germs are everywhere—on 
the instruments which cause the wounds, on the skin of the patient, in 
the sweat glands of the skin, at the roots of the hairs, and on the hands 
of the operator, especially under the nails. Again, a great obstacle to 
the free action of antiseptics is grease or oil of all kinds, A fine coating 
of grease enveloping a germ offers great resistance to the action of 
antiseptics, and the object of the process of cleansing a wound described 
below is, first, to remove all the grease, and then to apply the antiseptic 
to destroy the germs. With care, a clean-cut wound should heal kindly, 
without the formation of matter. 
To dean and dress a Wound . 
First cover the wound itself with a small piece of cotton-wool or lint, 
wrung out in an antiseptic solution; then thoroughly scrub the sur¬ 
rounding skin with warm water and soap (soft soap for preference), 
using a nail brush which has been previously boiled. 
