Treatment.—The wound in such cases must be treated as described in inflammatory fever. Internally the usual remedies are given. A local application of sixty-per-cent ichthyol ointment, covered with salicylated cotton, serves best. The skin may be incised in various places, washed with an antiseptic (sublimate solution 1-1,000) and the serous exudation pressed out with the sterilized hand, after which the above ointment is applied under absorbent cotton (Glück).
Antithermic remedies, as obtained by the application of certain alkaloids, such as cocain, spartein, solanin, helleborin, have been successfully used by Guimard and Geley.
Spartein is especially claimed to exert a happy influence.
Lately a product under the name of antiphlogistin has been used locally with excellent results and its use is to be commended even in local wound inflammation.
If the subcutaneous tissue is affected and the surface indicates the breaking down of tissue, hot antiseptic applications are advisable or the skin is incised down to the deep fascia at such places and iodoform gauze is packed into the wound for several hours. Constant antiseptic irrigation is then established by means of drainage tubes inserted into the various incised places, which are connected to an irrigating apparatus, so that the antiseptic may reach all parts of the infected area.
Nontoxic solutions are indicated in this event; of these, hydrogen dioxid, three per cent, and boric acid, nine per cent, are most suitable. The solution is allowed to trickle gently through the wound and is led off by open tubes, that may be connected in such way as to empty into a receptacle placed beneath the bed.
CHAPTER VII
ANESTHETICS
Anesthesia of the human may be accomplished in two ways: first, by the employment of a general anesthetic, and, secondly, by the local use of a narcotic agent.