^x4. Sir Rickmaii John Gocllee [:\Iai'cli 12, 



antiseptic he tried was carbolic acid, and as the crude sample he first 

 worked with was insoluble in water he used it undiluted. 



His plan for treating compound fractures was, after cleansing the 

 wound, to sponge the whole of the raw surface with this undiluted 

 crude German creosote in order to destroy the germs introduced l)^ 

 dirt or other foreign material at the time of the accident, or that, as 

 he supposed, had been carried to it by the air. The carbolic acid 

 mixed with the blood, caused an antiseptic crust, which he fortified 

 by covering it with a thin piece of block-tin, and this crust effectually 

 prevented the access of unpurified air to the wound ; for he left it 

 undisturbed for days or wxeks and painted the outside with more of 

 the undiluted acid from time to time. 



I wish to impress upon you that in the earliest dressings he used a 

 very strong antiseptic and did his best absolutely to exclude the germs 

 in the air, and it is important to note that his results were strikingly 

 good, in spite of the fact that the undihited acid did actually cause a 

 certain amount of superficial sloughing — or death of the tissues — 

 in the parts to which it was applied. As time went on a purer 

 carbolic acid was obtained which dissolved in water, so he abandoned 

 the caustic undiluted acid in favour of a saturated watery solution : 

 1 part to 20. ' 



He soon extended the treatment, first to abscesses and then to 

 ordinary operation wounds. The old antiseptic crust was soon given 

 up, and various dressings containing carbolic acid or other antiseptics 

 were employed instead. But for a long time he was so anxious about 

 the air that he irrigated the wound with a solution of carbolic acid 

 in water throughout an operation, and took the most elaborate 

 precautions against allowing any air that had not been submitted to 

 the influence of carbolic acid to reach the wound at the changing of 

 the dressings. He used to say that merely taking out a drainage 

 tube without antiseptic precautions involved a serious risk, because 

 the air which rushed in to take its place might carry some speck of 

 dust and a germ along with it. 



In his most palmy days, when he was professor of clinical surgery 

 at Edinburgh (1869-77), and Edinburgh was for the time the 

 surgeon's Mecca, he introduced the spray in order to deal still more 

 effectually with the air. In its most highly developed form the 

 steam spray-producer threw a copious vapour, which was supposed to 

 contain one part of carbolic acid in forty of water, that surrounded 

 the whole region of the operation, and, if the room were small, might 

 even fill the whole apartment with a pungent vapour, to the great 

 discomfort of all concerned. He thought at the time that the 

 momentary contact of the dust with the particles of carbolized water 

 in the spray, or the carbolized atmosphere between the drops would 

 be enough to destroy the germs ; but in after years he owned that 

 such a result w^as impossible. 



At this period, though he was still using strong antiseptic lotions 



