(Extract from "Evening Chronicle," 26th July, 1915.)
In ordinary times of peace the surgeon rarely sees a wound that is infected—a state of affairs that has given birth to the axiom that in modern surgery antisepsis has been replaced by asepsis. In the recent war, more so than in the South African War, owing to the changed character of the missiles (whose effects recall those inflicted by the "Brown Bess" in the old days), the wounds received have been so terrible that infection on a large scale becomes inevitable, and, further, in almost every instance scraps of infected clothing or other infected material have been driven into the wound, with the result that the severely wounded tissues have become infected on a scale that is without precedent.
While this experience was novel, the majority of the surgeons practising in France relied on a more stringent application of recognised methods. Tissues were deluged with powerful antiseptics, strong carbolic acid even being employed. The success obtained was, however, trifling, and a new system, based on one of the most beautiful discoveries in physiological physics, has been substituted for the older method.
It is a commonplace of modern discovery that if a vessel is divided into two compartments by an animal membrane and the solutions on the two sides of the membrane are different concentrations, liquid will pass from the weaker to the stronger solution until ultimately both are at the same strength.
Experience at the base hospitals has shown that this system of treating severe wounds is more effective than any vain attempt at subduing the infection by antiseptics, and the method now being followed with success is thoroughly to cleanse the wound, to provide an effective system of drainage, and also to have in the wound a liquid (a mixture of sodium citrate and sodium chloride is usually employed) at a considerably greater concentration tham that in the serum of the blood.
Under the influence of the liquid the serum of the blood, which has strong antiseptic properties, is poured out from the body into the wound, tending both to cleanse it and to destroy the bacteria that are present. Clearly the system has the great advantage in that, if it is used with discretion, the tissues are left uninjured by the fluids used for the destruction of the bacteria, and the full recognition of its efficiency in the case of severely infected wounds must be regarded as one of the most important advances made in surgery as a result of the war, the chief exponent and originator of the new method being Sir Almroth Wright.
Comment.—In regard to the above treatment, we are pleased to see that Sir Almroth Wright is becoming a convert to Physio-Medicalism. This method of treatment has been known to Herbalists for nearly 100 years, but with other remedies different from Chloride of Sodium (common salt), which have been the causes of their great successes in healing wounds. Sixty years ago Dr. Skelton used No. 6 (Thomson's Compound Tincture of Myrrh) for healing wounds, and was very emphatic in stating that no deleterious matter can find lodgment in the tissues if this be used. In regard to Sodium Chloride (common salt), it was once used to wash over the bruises of prisoners who had been flogged. No. 6 never fails, and is the greatest vegetable cleaner of wounds, healer, and antiseptic in existence.—R. L. Hool.
Common Plants and their Uses in Medicine was written by Richard Lawrence Hool, F.N.A.M.H., in 1922.