])abu!um for bacterial growth. When this was suf- ficiently understood, the next step was taken. The wounds were excised, at first gingerly and with many misgivings, but as case after case proved the correctness of the theory, the confidence was gained that Clomipramine Hydrochloride Tablets herein lay the crux of all the previous trouble. The whole wound, no matter what its condition, is excised in one piece whenever possible, well into the normal tissue, regardless of mutilation, for in wide excision and only in that lies the safety of the patient. Clomipramine Hydrochloride While this method of dealing with these horrible infections was gradually being evolved and im- I^roved, Rutherford Morison, in charge of several base hospitals under Sir Berkeley Moynihan had compounded a mixture which he named Bipp, consisting of Anafranil Clomipramine equal parts of bismuth, iodoform, and parafiin. This he sprayed into the incised clean wounds, and v/as so impressed with tlie rapid heal- ing, that he went a step further. He took several of these unspeakably foul wounds, excised them according to the method that had been developed and sprayed them with the Bipp, and sewed them up tight. He got union by first intention, a marked advance over tJie precarious Carrel-Dakin method. Sir Berkeley Moynihan was impressed by the re- sults obtained by Rutherford Morison, but upon analyzing the various steps of the procedure, he came to the conclusion that so small Clomipramine 50mg a quantity of Bipp was used by Morison, that he did not believe it had much to do with the healing of the wounds. So, as he expressed it, in a moment of exaltation, he instituted at one of his hospitals the hipping of these wounds without the Bipp. In other words, after excision he sewed them up as any other clean wound, and eighty per cent, of the wounds healed by first intention. So out of chaos has come order, and instead of relying on antiseptic surgery in these cases, they are brought back into the realm of aseptic surgery, and eighty per cent, heal by first intention. Even gas Clomipramine 50 Mg gangrene Clomipramine 25mg has been conquered by these measures. Ihe mfiexiblc rule now is, if possible, cut out the wound in one piece. If this is impossible, every part of the wound Clomipramine 10 Mg is cut out, so that not a particle of the Old wound surface remains, and as Doctor Crile said, 'Tt makes one's hair stand on end when first seeing wiiat has to be done." But it is the one es- sentia! thing, do the work the maggots did. only do it quicker and in a thorough manner. 7'he statement was made by all the writers, that doctors in civil life, have absolutely no conception of tlie horrible Buy Clomipramine Online condition that these wounds get into, in a few hours. The reason for it lies in the Flanders mud which is everywhere. The men sleep in it, work in it, cat in it, they become coated with it outside, it is an ooze that pervades every- thing, no one can escape it. It even becomes the missile that inflicts the wound. When a Buy Clomipramine high ex- plosive shell explodes, it transmits enormous energy to everything that it Clomipramine Ocd strikes, and often through a small openiiig in the skin, a large quantity of this mud is driven with sufificient force to shatter bones. It is this mud that carries the deadly contagion of (hese horrible infections, and the reason is clear. For centuries Clomipramine Buy the fields of Flanders have been sub- jected to intensive cultivation, and being easy to get, human excreta has been largely used as fer- tilizer. This had caused the soil to be imjiregnated with all the intestinal flora of the human family, as proven by the bacteriologists, and these organisms cause these intense and rapid pathological Clomipramine Tablets changes Clomipramine 20mg never seen before in wounds. It was the concensus of opinion that if the ele- ments concerned in wound healing could be reduced to the figure ino, the pait played by any anti- .septic would be less than ten, tliC remaining ninety parts would be rcDrcsented by the physiological re- sistance of the patient and com]iiete excision or free mechanical exposure of all parts of the wound and removal of all dead tissue with free drainage. In those wounds where excision and closure are impossible, recourse ;nust be had Clomipramine For Ocd to some antiseptic. The ideal antiseptic for war wounds has not yet 4i6 HERTZBERG: CLINICAL CONGRESS WEEK. [New York ;dic.