The treatment of wounds as based on evolutionary laws / by C. Pitfield Mitchell.

  • Mitchell, Charles Pitfield.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: The treatment of wounds as based on evolutionary laws / by C. Pitfield Mitchell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    22/30 (page 22)
    nature of a wound necessitate the use of a drainage-tube, to give exit to the deleterious products of tissue necrosis, we choose the lesser of two evils. Further improvement in treat- ment, therefore, is possible only by making further conces- sions to the physical and chemical conditions which the nature of things prescribes as indispensable for physiological repair ; and the general aim should be, while surrendering as much as possible to these conditions as “ theory,” to equally respect the claims of practice. Retaining the provisional conditions stipulated at the out- set, let us take an amputation of the thigh as an illustrative case. All surgical instruments—knives, scissors, forceps, drainage-tubes, sutures, etc.—are thoroughly cleansed in warm water and dried before being used. The hands of the operator and assistants, and the cutaneous surface of the part to be operated upon, are in like manner freed from all impuri- ties. [It has been shown to be inferrible a priori, and experience has abundantly proved, that “dirt”—using the word in the broadest sense—is inimical to the healing of wounds. The employment of antiseptics or other drugs for the cleansing of hands or instruments is discountenanced, because it has been conclusively demonstrated that ordinary germs are impotent and sterile in tissues and exudations if these be kept healthy. But healthiness, as here understood, is entirely a matter of molecular grouping, and therefore whatever is prone to disar- range the grouping which is natural—and antiseptics and other drugs are prone to do this—will be liable to lessen the stability of the tissues and exudations to the ever-acting and insensible forces of the medium to which they will be subjected. The hands and instruments are dried for the same reasons.] As a means for removing blood and clots from the raw surfaces, pieces, two or three inches wide, of old and washed, very dry linen, will, in general, be found eminently efficient. By using this material, rather than sponges or absorbent cot- ton, a high degree of cleanliness is attained, and the tissues and fluids are kept free from cotton fibres—they remain chem-