The Use of Liquid Paraffin in the Treatment of War Wounds.

DURING the past year muchclinical observation has been' carried out in several. :Casualty Clearing Stations in this Army on the effect of liquid paraffin upon wounds at different stages. The results of these observations enable one to state: 1. That liquid paraffin has, almost without exception, a very beneficial action on the walls of a wound and on the tissues adjacent to the wound. It prevents develop. ment of the symptoms of inflammation in these parts and will cause such symptoms to disappear rapidly if they are already present. The skin remains or becomes normal in appearance; redness and swelling do not develop or, if present, disappear. Pain is assuaged. Performance of function becomes easier, although, of course, this is frequently restrained by therapeutic agencies and is theretore not evident. Changes of dressings are comparatively painless. One does not care at this stage t6 discuss possible explanations of these effects 'of the paraffin, but it may be pointed out that the "-electrical " conditions of wounds have usually hitherto been entirely disregarded, only chemical and mechanical conditions -having been considered. Electrical conditions of wounds, as revealed by the galvanometer, are found to vary, in a very consistent way, with the age of the wouifd and the amount df inflammation present. 2. Liquid paraffin is not antiseptic in the ordinary sense of the term. If a wound be " packed" with gauze wrung loosely out of the.paraffin, it is found that in two to -four days the discharge-in the wound swarms with -organisms, although .the surrounding parts .are free from inflamma tion. The "wound" with the fluid part of its contents may be likened to a test tube containing nutritive medium in which organisms are thriving. In either case the addition of antiseptic will lessen or entirely inhibit the growth. If an antiseptic is dissolved or suspended in the liquid paraffin with which the gauze pack is saturated, it is found that the wound remains or becomes sterile. Various antiseptics or mixtures of antiseptics have been used, with good effects in all cases, although these effects vary, possibly owing to selective effect of the particular antiseptic against the particular organism or to tolerance acquired by the organisms for the antiseptic employed against them. Those chiefly used up to the present are flavine, brilliant green, boric acid, and iodoform. It is rather difficult to justify preference for' any one. A com. bination seems desirable. Non-poisonous antiseptics with more or less prolonged action when in contact with body fluids are likely to be most successful. It seems that, although the effects of micro-organisms on the tissues adjacent to a wound are inhibited, absorption of chemical antiseptics from the wound may occur and cause symptoms of poisoning. One would desire to draw attention to papers sent for ,publication by Captain W. H. Heyr and others (p. 506),