Richmond times-dispatch. [volume] (Richmond, Va.) 1914-current, 1917-08-19

(1) An undoubted action in destroying
microbes. Its strength is near to that of perox.
ide of hydrogen, weaker than that Of iodine
(2) An action on the organic surroundings
Of the wound through the rapid dissolution Of
diSintegrated tissues, pus bags, red globulcs
blood clots and muscular fbres These sub
stances form mechanical obstacle to the ac-
ton of the antiseptic upon the microbes and
favor the spread Of the latter.
(3) A mechanical action in driving dirt out
of the wound
(4) Finally, matter of capital mpor-
lance, surgical experience shows that while
the neutral hypochlorite dissolves perfectly
the dead and poisonous matter, it does not
inJure the living tissues of the wounds, which
on the contrary grow and fill up the space
created by the destruction Of the dead tissues
Other antiseptics and other substances may
possess to a more marked degree one of
these qualities, but they do not unite all of
them, and it is this combination which gives
the hypochlorites their great value
One of the advantages of Dakin's liquid
seems extraordinary and even mysterious This
is that it brings about by its antiseptic action
the formation of a cyst or membranous COW
cring over the wounded region.
Dakin's liquid, although it is a marked
germicide, is less so than the antiseptics
commonly employed hitherto in surgery, such
as Iodine bichloride of mercury perman.
ganate of potash, peroxide of hydrogen, etc.
This fact involves the necessity of using it
very frequently, proceeding which is with
out harm to the tissues, in contrast to what
happens when strong antiseptics are used
Torn fragments of flesh and bullet tracks
are especially the places where the mi
crobean flora will spread quickly. Between
the moment of the wound and that when
the microbes cover the whole extent of the
wound there is but very short time-from
SIX to twenty-four hours on the average
We shall now understand why Dr. Carrel
insists on the necessity Of largely opening
up the wound, of extracting from it all for
eign bodies and of beginning as early as
possible the continuous moistenng of the
wound with Dakin's liquid We must add
that majority of doctors who have used
the Carrel method think that the results
are especially favorable when the doctor can
give the treatment within the first six hours
The surgeon will therefore act as quickly
as surrounding circumstances permit, while
not neglecting any of the usual features
which accompany wound, such as shock.
The first stage of the treatment will be to
open up freely all intricate cavities and all
recesses in the wound and in fact every
corner which suggests partially closed cav
ity. AT the same time, Dr. Carrel holds that
it may be useful to cut away the ragged
edges of the wound. In the course of the
treatment the surgeon takes care to remove
all foreign bodies, not trusting to the sense
of sight and touch alone, but having re-
course to the X-rays and even, if possible,
to the electro-vibrator
AS in any other surgical treatment, it must
be understood that it is necessary to limit
the extent of the operatory enlargement of
the wound, to avoid bad scar and to stop
the loss of blood.
The operative cleaning of the wound,
which must be very methodical and COM
plete, is followed by the chemical cleaning.
The Carrel apparatus consists of tiny rub
Der tubes which are pushed into every cor
Copyr