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^ pnn t tvttr OTT IN INFECTED WOUNDS : CHATTERJEE 721

Dec., 1937] USE OF. COD-LIVER OIL liN liNJ

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the use of cod-liver oil in INFECTED WOUNDS

% B. CHATTERJEE, m.b., d.t.m. (Cal.), l.m. (Dub.)

-Medical Officer, The Chargola Valley Medical Asso-

ciation, Dullabcherra, Sylhct., Assam

Since the appearance of an editorial article in

the Gazette of February 1937, regarding the use

of cod-liver oil for dressing of surgical cases, I

have tried it on more than one hundred cases, with uniformly good results. Some of the cases

were cured in a very short time, and I think

gome of my results may be of interest.

(1) The most remarkable case was one of mauling fl tiger. The man?a tea-garden labourer was very

badly injured over his head and right forearm by a iger. The wound on his head was a longitudinal one>

^bout 5 inches in length, extending from an inch above

the forehead to a little above the occipital protuberance. An '

S ' shaped vertical wound, starting from a little

.ove the right ear, met this longitudinal wound at its

middle in such a way that two triangular flaps of scalp

}\ere hanging over his right ear, when he was admitted mto the hospital. The skull was exposed over the

greater part of the wound. He bled profusely and Avas m a state of shock when admitted. There were some

smaller wounds on his forehead also. Another

gaping wound, nearly encircled the upper part of his

IJght forearm, exposed the supinator muscles, the fibres

oi which were torn in places. Just below this wounc

here were four or five deep punctured wounds, probably

ca^d by the tiger's teeth. . , ,

Jne man was attended to, within a very snort

tune after the incident. The wounds were

cleansed as thoroughly as possible. The scalp wounds were stitched up, hoping for the

best.

Anti-tetanic and antistreptococcal serums were ejected, and all the wounds were dressed

witli

gauze soaked in cod-liver oil. For the next

three or four days, the man was in, a bad condi-

tion. Plig temperature went up between 103

and 104?F., and he was somewhat toxic. But

luckily from the fourth day he began to show

'^gns of improvement, the temperature settled

down to 99?F., and the extreme pain in the

Wounds, of which he had been complaining, was

markedly less. From this day he improved steadily. The stitches were removed on the

tenth day. The whole of the head wound and

tlie other wounds healed by first intention,

except a small patch over the middle of the

head, which took about another ten days to heal.

% the end of three weeks he was quite well,

except that he was still weak and somewhat

anaemic. He was treated for his general weak- ness for another two weeks, and by the fifth

Jveek, he was back at his usual work. It may

be noted, that all his wounds were treated with

nothing but cod-liver oil, after cleansing them with methylated spirit.

.

I have treated several tiger bite cases pre-

viously ; several of them were cured, but none of

them recovered so quickly, and without any

complications, and I think all the credit is due

to cod-liver oil. (2) A case was of indolent ulcer, of more

than six months' duration, on the outer side of the left foot, extending from the heel to the

middle of the foot. He was dressed with cod- liver oil only, and was completely cured within three weeks.

(3) A European gentleman suffered from a

suppurating sebaceous cyst, about the size of a medium-sized orange, on the middle of his back. This was operated on under local anaesthesia. A large quantity of pus was drained out, the capsule was dissected out piecemeal as far as possible, but the cyst could not be shelled out as it was very adherent to the surrounding muscles. The cavity was packed with sterilized gauze soaked in cod-liver oil, which was also used in dressing the wound all through, and it was healed in three weeks. There was no sup- puration throughout the course of healing, and the cavity filled up from the bottom by granu- lation.

(4) A case of extensive cellulitis of the right hand and forearm was treated with cod-liver oil dressings after operation and was cured within an unexpectedly short time.

(5) Four cases of extensive burns were treated with cod-liver oil dressings with most gratifying results. This treatment seems to be better than picric acid and tannic acid treatment. The successive dressings were painless, healthy granulations formed very quickly (sometimes so quickly and profusely that they became exu-

berant, and had to be kept down by applications of copper sulphate), and skin appeared in patches all over the wounds, within a very short time.

(6) A very chronic and troublesome case of sycosis of the thighs, legs and forearms of a

patient, becoming worse in the rainy season for the last six or seven years, was previously treated with many kinds of remedies and with stock and autovaccine. But none proved suc- cessful. Then he was treated with daily gentle massage of the infected areas with cod-liver oil, and now he is apparently cured. This is the first rainy season in the last six or seven years that he has been free from his trouble.

(7) A case of Naga sore also healed up miraculously. He had two typical sores, each about the size of a rupee, on the dorsum of his foot, about an inch above the roots of the toes In spite of all kinds of local treatment, one of the sores gradually extended between the fourth and the fifth toes, and burrowed deeply at the root of the little toe, and it was feared that this toe might fall off, if the extension was not checked. At last we resorted to cod-liver oil treatment. The wounds responded marvellously and were healed up within two weeks, and he was fit for his usual work on the third week after this treatment was begun. At this time, I treated four more cases of large and multiple Naga sores with cod-liver oil, but the response was not so striking as in the case cited above. At present there are 21 cases of Naga sore under my treatment. Some of them are showing very

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satisfactory improvement (7 of them have become fit within 10 to 23 days), but others are not responding as satisfactorily. To compare the

efficacy of different drugs, I treated different sores with different things?phenol, copper sul- phate, normal saline, etc.,?but my general im- pression is that the action of cod-liver oil is

quicker than that of the; other remedies.

(8) Four cases of otorrhea (one complicated with mastoid abscess, which had (o be operated on) were all cured within a very short time. Another case of otorrluea of both the ears, as

a complication of typhoid fever, was satisfac-

torily cured by cod-liver oil drops. (9) One case of badly lacerated wound of the

hand, caused by a crushing machine, was treated with cod-liver oil, and it healed up without

suppuration. The remainder of my cases were ulcers and

septic wounds on various parts of the body. The peculiarities I have noticed about cod-

liver oil treatment of wounds were?

(i) Checking of formation of pus in fresh

wounds, and quickly clearing away of pus in

already septic wounds. (n) Rapid formation of granulations, which

often became exuberant.

riVo?e.--This is essentially an account of clinical results without controls; unfortunately the exigencies of practice and the necessity of curing cases as rapidly as possible rarely allow of controlled observul ions under such conditions.?Editor, I. M. G.1