5* 
Current  Literature. 
I  Am.  Jour.  Pharm. 
^     January,  19 18. 
Secondary  suture  gave  good  results  in  all  the  cases  in  which  it 
was  adopted.  In  open  wounds  on  removal  of  the  first  dressing  on 
the  third  day  the  wound,  except  for  being  deeply  stained  with 
flavine,  has  undergone  no  alteration  whatever  in  its  appearance, 
and  resembles  an  injury  only  a  few  hours  old.  All  signs  of  inflam- 
mation are  wanting,  and  there  is  no  pain,  redness,  swelling,  or  in- 
duration in  the  tissues  around.  The  secretion  from  the  wound  is 
minimal  in  amount  and  suppuration  is  absent.  The  complete  ab- 
sence of  suppuration,  even  in  wounds  where  films  show  abundant 
organisms  to  be  present,  is  a  noteworthy  feature  in  wounds  under 
treatment  with  flavine.  When  dressed  again  at  the  end  of  a  week 
the  skin  edges  are  found  clean  cut,  no  epithelial  growth  having  taken 
place  from  the  edges.  The  floor  of  the  wound  has  by  this  time 
become  covered  by  a  closely  adherent  membrane,  only  detached 
with  difficulty  from  the  underlying  structures.  This  yellow  pellicle 
forms  over  whatever  tissue  is  exposed  in  the  wound,  whether  it  be 
muscle  or  subcutaneous  fat.  Experience  has  shown  that  a  wound 
heals  with  much  greater  rapidity  if  the  flavine  be  stopped  after  three 
or  four  days  in  the  case  of  small  wounds,  and  after  about  a  week 
in  the  case  of  severe  wounds  or  compound  fracture. 
Flavine  appears  to  have  many  advantages  as  a  primary  treat- 
ment of  recent  war  wounds.  Among  the  advantages  are:  (a)  The 
absence  of  all  toxicity,  even  in  large  wounds,  (b)  The  prevention 
of  suppuration  and  of  spreading  sepsis,  (c)  The  primary  dressing 
need  not  be  changed  for  two  or  three  days,  and  is  then  easily  and 
painlessly  removed.  This  may  be  of  great  advantage  during  severe 
fighting,  where  rapid  evacuation  of  wounded  from  front  to  base  is 
required  without  unnecessary  dressing  of  the  wounds,  (d)  The 
wounds  are  not  inflamed  and  painful,  and  the  surrounding  skin 
is  never  irritated.  Flavine  cannot  be  classed  as  a  success  in  the 
treatment  of  the  later  stages  of  war  wounds.  The  wounds  tend  to 
assume  a  stagnant  condition,  during  which  the  processes  of  repair 
are  almost  in  abeyance.  After  a  few  days,  when  the  danger  of 
gas  gangrene  and  of  spreading  sepsis  have  to  a  great  extent  passed 
off,  flavine  should  be  stopped  and  another  treatment  adopted.  In 
the  majority  of  cases  war  wounds  are  not  rendered  bacteriologically 
sterile  even  by  the  prolonged  use  of  flavine.  Test-tube  experiments 
carried  out  with  organisms  isolated  from  actual  wounds  bear  out 
the  strong  antiseptic  properties  of  flavine,  and  their  enhancement 
