alone be allowed to pass in the changing of the dressing.
The putty should be in a layer about a quarter of
an inch thick, and may be advantageously applied rolled
out between two pieces of thin calico, which maintain
it in the form of a continuous sheet, which may be
wrapped in a moment round the whole circumference of
a limb if this be thought desirable, while the putty
is prevented by the calico from sticking to the rag
which is next the skin.[Footnote: In order to
prevent evaporation of the acid, which passes readily
through any organic tissue, such as oiled silk or
gutta percha, it is well to cover the paste with a
sheet of block tin. or tinfoil strengthened with adhesive
plaster. The tin sheet lead used for lining tea
chests will also answer the purpose, and may be obtained
from any wholesale grocer.] When all discharge has
ceased, the use of the paste is discontinued, but
the original rag is left adhering to the skin till
healing by scabbing is supposed to be complete.
I have at present in the hospital a man with severe
compound fracture of both bones of the left leg, caused
by direct violence, who, after the cessation of the
sanibus discharge under the use of the paste, without
a drop of pus appearing, has been treated for the
last two weeks exactly as if the fracture was a simple
one. During this time the rag, adhering by means
of a crust of inspissated blood collected beneath
it, has continued perfectly dry, and it will be left
untouched till the usual period for removing the splints
in a simple fracture, when we may fairly expect to
find a sound cicatrix beneath it. We cannot,
however, always calculate on so perfect a result as
this. More or less pus may appear after the lapse
of the first week, and the larger the wound, the more
likely this is to happen. And here I would desire
earnestly to enforce the necessity of persevering
with the antiseptic application in spite of the appearance
of suppuration, so long as other symptoms are favorable.
The surgeon is extremely apt to suppose that any suppuration
is an indication that the antiseptic treatment has
failed, and that poulticing or water dressing should
be resorted to. But such a course would in many
cases sacrifice a limb or a life. I cannot, however,
expect my professional brethren to follow my advice
blindly in such a matter, and therefore I feel it
necessary to place before them, as shortly as I can,
some pathological principles intimately connected,
not only with the point we are immediately considering,
but with the whole subject of this paper. If a
perfectly healthy granulating sore be well washed and
covered with a plate of clean metal, such as block
tin, fitting its surface pretty accurately, and overlapping
the surrounding skin an inch or so in every direction
and retained in position by adhesive plaster and a
bandage, it will be found, on removing it after twenty-four
or forty-eight hours, that little or nothing that
can be called pus is present, merely a little transparent