HEALING WOUNDS, BY lit RIGATION.

Grey River Argus, 20 April 1917, Page 4

HEALING WOUNDS, BY lit RIGATION.

There is a great hospital in Franco v solely given over to the treatment oi' wounded soldiers. There are many such hospitals in Fiance, and England and crowded over the face of Europe, but this one hospital in France is unique, for in no man has yet died from the effect of his wounds (says a London paper) v The hospital is built at Compeigne, and was established after the outbreak of war by the KockerJfel- ! ley Ilospsmih Institute for the jnuyiose of testing a new method of healing; deep wounds, devised by rke famous French surgeon, Dr. Alexis Carrel. Before the war Dr. Carrel was probably best known to the general public as the man who grafted the leg of a black dog upon the body of a white dog so successfully that the dog was able to- scratch himself with the claws of the transplanted leg. The ■■American Sunday papers hailed him because of some, astonishing experiments conducted in the rejuvenation of old dogs and' cats. Scientists recognised of course, that Dr. Carrel's "modern miracles" were only, picturesque incidents in an important investigation into human tissues, and that the surgeon stood on the eve of a discovery that would be vastly more important to humanity than the accomplishment of gruesome tricks with cats and dogs. (The war directed Dr Carrel's investigation into one particular channel, led to the discovery in the treatment of wounds of what is now known as the "Methods de Irrigation Intermittent Carrel," and has given the hospital at Compeigne its wonderful record of rapid and efl'ective cures. It took only a y few months' experience of war to show the French surgeons that the greatest service that science could render to the mdical profession would be cheap and thoroughly practicable methods for the speedy sterilisation of deep -wounds, an end towards which Lister started blazing th c trail, but along which' trail coin-' jparatively little progress ' had been made until a couple of years ago. Carrel, therefore, adopted better sterilisation, perfect sterilisation if humanly possible, as his line of endeavour. The Kockerfeller Institute put its unlimited resources at his disposal, and this enabled the surgeon to elicit the aid of the best special talent that the world, outside of the Central Powers, afforded. >

It has generally been admitted that the difficulty in effecting a complete sterilisation of deep wounds in the past has been entirely on account of the trouble in reaching anything but tiic surface with the antiseptic. Dr. Carrel, at the outset, conceived the idea that, just as one washes a sponge by repeated sturations and wringings, so should a wound be washed by some sort of a "flushing" system that would send an antiscptie solution to evfery part of the wound. For this ■two things were obviously necessary — first, a proper solution, and, secoiul, a proper apparatus for applying or* distributing it. The aid of the English chemist, Mr. H. D. Dakin, was elicited in discovering the solution, and after exoeriments with more than 200 mixtares the solution now in use — a one half of one per cent solution oiMiypoof soda, to which is-added a small amount of boric acid — was . decided upon. This is really only a very pure oxygenated solution of common salt. A great point in its favour is its negligible cost of three centimes per litre.

In experimenting with the apparatus, Dr. Carrel first imi&g tests of allowing the liquid to fall upon the surface of the wound from above, and then drawing it into the wound and carrying it away through the action of a suction pump working on a number of perforated rubber tubes buried in the •■. flesh. Ultimately this plan gave way to practically its reverse — that of carrying the solution to the wound in perforated tubfcs buried in the flesh and allowing ii? to drain away by gravity. By the system as finally perfected, and as at present in use, the solution is carried in a receptacle at the heafl or the foot of the bed, and once every two hours, by opening a pinch-cock on the main rubber tube leading down to the wound, the latter is thoroughly flushed with the liquid under a 4ft or sft pressure. -

No sooner was the system v put into regular operation than striking evidences of its efficacy were apparent. The daily microscopic examinations showed that the bacteria of .infection

in wounds under treatment were decreasing at a rate never known before, with the result that the actual healing of the wounds was accomplished in far less time, often from a half to a third than they had required under ordinary treatments. When the microscopic study- showed the disappearance of all traces of infection, it was found practiceable to close the wound, either by stitching or with adhesive plaster, aY once. The wound was as good as healed, and with the incalculable a<lvantiioe over the old way of cicatrisation that the area of stiff, useless scar tissue was reduced almost to nothing. Ninety per cent ahoN more of the area covered by the original wound was replaced by firm, pliable, serviceable flesh.

Not the least important and interesting development from the discovery of the "method Carrel" has been the mathematical Avorkiitg out of a" law of cicatrisation." Dr. Carrel noted Jthat the rate of healing of a number of wounds as plotted on the chart showed a remarkable regularity. The assistance of the French physicist and mathematician Dr. Nouy was sought in establishing a formula, and, incredible as it may seem, the progress of patients in the Compicgne Hospital can now be almost exactly calculated on a graph, and the day of. their cure accurately predicted. Dr. Nouy obtained the "Index of Cicatrisation" by workiuff it out from the age of the man and the difference between the~ area of the wound on the first day of treatment and on the fourth. By plotting but "lines of healing" for the men of 40, 32, 30, 25, and 20 years, it was possible to obtain the index by simply drawing a horizontal line from the point indicating the size of the , wound in square centimetres, to cut the curve of the age of the. patient, and dropping a perpendicular from there to the base line. When the index Avas obtained, all that was necessary was to put it into the formula, and work out the result, which Avas the number of days it should take tjie wolihd to heal under treatment by the "method Carrel." The actual curve oi' heaihiy of all normal wounds- has \ worked out practically identical with the theoratieal curve in ninety-nine case out of a hundred. Th e great practical value of being able to calculate the curve of healing in advance is the standard it sets for the rate at Avhich the wound. oughf close. Any. sharp deviation from the curve- indicates at once that something is wrong. Incidentally, too, it enables the hospital authorities to figure weeks in advance the rate at which beds will be vacant to receive new ones,