Excerpt from Edinburgh Medical Journal, Vol. 22

Several others have written with equal enthusiasm about the superiority Of the salt pack over other methods of wound treat ment, but no one, with perhaps a single exception, so far as I remember, has recorded any failures. Perhaps they had none to, record. It was a failure, however, that led to my undertaking the investigation on which the new method of treatment rests.

My colleague, Major Joyce, had noticed that in one or two instances the salt-pack treatment had been a failure, and in such this method had to be abandoned for some other. The reason for' these failures was not at first apparent, until he became aware that whereas all successfully treated salt-bag wounds emitted a strong Offensive odour - a characteristic referred to by all who have written about this particular treatment - it was completely absent from certain cases under his care which had definitely failed to clear up after salt packing. No surgeon hitherto had coupled absence of smell with failure of the wound to improve under salt-bag treatment. It was a point, however, of consider able importance, for on it hinged the subsequent laboratory work upon which the new method is based.

Impressed by the observation he had made, my colleague approached me with the query, Why do some salt-packed wounds. Smell while others fail to do so? The simplest and most obvious answer to the question was that a certain organism or combination of organisms, present in some wounds but absent from others, would probably be found responsible for the Odour in question.

To determine if this were so became my immediate aim. In the course of investigation, however, new ideas occurred to me as well as fresh problems for solution, and these, when they had been followed up, elucidated and tested, furnished the data for the method of treatment as formulated in these pages. In carrying out this inquiry I am indebted to my colleague, Major Joyce, for affording me free access to the patients under his care, for granting me every facility for the collection of material and clinical data, and for his kind co-operation when the time came to put the new method to clinical test.

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