A guide to the aseptic treatment of wounds / by Dr. C. Schimmelbusch. Preface by Prof. E. von Bergmann. Tr. from the 2nd rev. German ed. with express permission of the author / by Frank J. Thornbury.
- Curt Schimmelbusch
- Date:
- 1900
Licence: Public Domain Mark
Credit: A guide to the aseptic treatment of wounds / by Dr. C. Schimmelbusch. Preface by Prof. E. von Bergmann. Tr. from the 2nd rev. German ed. with express permission of the author / by Frank J. Thornbury. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
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![tire extent. The extraction of the drainage tubes with the change of dressing is the simpler and better method. Allow- ing them to protrude through the gauze, or attaching threads to them to facilitate their removal in course of a few days, is not to be recommended, as the position and aseptic character of the dressing are thus jeopardized. A direct external com- munication is created. The frequent changes of dressing in the former Lister method was regarded as necessary in order to enable the surgeon to determine early whether infection had anywhere taken place. Necessity for this seems very apparent. With the occurrence of infection most energetic measures are to be adopted. All, or the greater number of the sutures should be removed, the wound laid open, packed with iodo- form gauze, and drained. In the permanent dressing of to- day the direct control of the wound is excluded, and so much the more thoroughly must the surgeon study the symp- toms which indicate to liim, without such ins])ection, the presence of infection. It is very essential to understand the normal process of recovery. In case of the mammary ampu- tation referred to, sensitive jiatients will complain of some pain on the day of the operation. On the following day, if the course is aseptic, this is substituted by simply a feeling of dis- comfort, due to the dressing. As the effect of the chloroform passes off, vomiting and headache subside, and the appetite and normal sleep return, so that in the course of thirty-six to forty- eight hours a quite natural condition is resumed. The char- acter of recovery under the Listerian dressing led surgeons to suppose that where there is no reaction in wounds the patient is always free from fever. This is incorrect. Every experi- enced clinician will endorse the following statement of Volk- mann ; It will very nearly be a true representation of the facts to assume that of one thousand cases of severe injury, properly treated, with all the aseptic j)recautions, only one](https://iiif.wellcomecollection.org/image/b21004948_0220.jp2/full/800%2C/0/default.jpg)
