Dalziel's article on Wounds is given complete: "For the purpose of description these can be divided into Incised, Lacerated, Punctured and Contused.
"Incised Wounds are those caused by a clean cut, such as a sharp-edged instrument. Lacerated wounds are those in which the tissues are torn and the edges of the wound irregular; punctured wounds those caused by stabs or probes; while contused wounds are those due to crushing and bruising.
"The process of healing is accomplished in different ways, according to the nature of the wound and the condition of the surrounding parts.
"1. First intention - that is, by immediate reunion of the parts.
"2. Adhesive inflammation, in which there is an exudation of lymph in both cut surfaces.
"3. Granulation, where the wound gradually heals by the formation of proud flesh.
"4. The union of granulations.
"5. The commoner and more usual method of healing, under a scab.
"In incised wounds the parts should be cleansed, and the bleeding arrested, any hair should be removed, and the lips or edges of the wound brought into immediate contact by sutures. Where practicable, the whole should be covered with dry carbolized tow and a bandage. A muzzle must be worn, or the stitches will be torn out, causing an unsightly wound that must then heal by granulation, while instead of a very slight scar, a large one will be the result. In adhesive inflammation the mode of treatment is the same; it has, however, been proved beyond doubt that dry dressings are much preferable to any other. The old method of dressing with oils, etc., is no longer continued. The commonest method of healing is by granulation under a scab as already noted.
"In wounds I have found the carbolized tow and carbolized gauze the most successful. The object of these is to prevent suppuration, if possible, by keeping the hair aseptic. Especially is this the case when one is trying to heal a wound by first intention, or by adhesive inflammation. In other wounds it keeps them healthy. The wound must be constantly washed and kept thoroughly clean. If it is a serious one, or there is much discharge, it should be dressed twice a day. Where proud flesh appears, it should be kept under by the application of nitrate of silver; again if the wound is unhealthy-looking, and the healing process is retarded, a slight application of nitrate of silver will often stimulate it to healthier growth.
"In all cases where the wounds heal by the process of granulation it is absolutely necessary that the repairing process should begin at the bottom, and so gradually close the wound. Should it occur at the surface, the pus will be imprisoned, burrow between the muscles, and find an exit or exits elsewhere in the shape of abscesses; or the pus will form sinuses, which will necessitate making large incisions. All wounds should be examined well for the purpose of detecting the presence of foreign matter, and again hemorrhage (bleeding) must be stopped before suturing.
"In puncturd wounds, the wound should be explored by means of a silver probe, so that the exact extent of the injury can be ascertained, and foreign matter removed. If this latter is overlooked, the result is often blood-poisoning and death. Punctured wounds must always heal by granulation; where there is any suspicion of foreign matter, always have recourse to a poultice.
"Contused wounds are generally successfully treated by poulticing and fomentations, but if the injury is severe, sloughing may take place. The final healing is by granulation. Always bear in mind to keep the wound clean.
"To summarise the general treatment of wounds. First stop the bleeding, remove the hair and examine for the presence of foreign matter, and where this exists remove it. If there is any doubt about it, apply a hot poultice night and morning until satisfied that the wound is cleansed; where it is practicable, always insert sutures to keep the edges together.
"As I have already said, dry dressings are the most successful, such as carbolized tow, and gauze (Listers' carbolized gauze) with a pledget of tow over it, kept in position by a bandage. In some situations this is not possible. The wound should be dressed night and morning with carbolic lotion: Carbolic acid 1 part, water 20 parts, with a little glycerine added. Or a saturated solution of boracic acid will do equally as well."