INTRODUCTION XXX] 
lead, moulded in a concave form so as to fit over the mass of lint. It was fixed 
in position by strips of adhesive plaster, the limb being placed in suitable splints. 
The carbolic acid and blood mingling in the small piece of lint formed a thick 
paste, and converted the whole into a sort of crust or scab, which adhered to the 
wound with great tenacity. Once a day the tin cap was removed, and the crust 
of lint and blood was painted over lightly on its outer surface with carbolic acid. 
What was aimed at was to keep this crust from becoming septic, while its under 
surface in contact with the wound, becoming gradually free from the carbolic acid 
which it at first contained, should cease to be irritating in itself, and therefore no 
longer interfere with the process of healing. The dressing was of the nature of an 
artificial scab, but with this difference, that the substance of the scab was charged 
- with an antiseptic introduced with the object of destroying any germs of putre- 
faction which might find their way to the scab from the skin, or from the splints 
padded with soft absorbent material to receive such bloody discharges as oozed 
from the wound during the first day or two. It was, however, recognised that 
the vapour of the carbolic acid retained under the cap of tin interfered with the 
process of cicatrization, and therefore, after it seemed likely that the wound was 
so far repaired as no longer to communicate with the seat of fracture, the anti- 
septic crust was detached, and the final closure of the surface wound allowed to 
take place under some simple form of dressing. 
The results of the application of the principle to the treatment of compound 
fractures could not have been more striking, for the patients suffered neither 
from putrefaction and inflammation in the wound nor from general septic 
diseases. The necessity for primary amputation in the majority of cases dis- 
appeared, many limbs and lives were saved, and the treatment of these injuries 
underwent a radical change. 
There is no instance in the history of surgery, and indeed few in the history 
of science, in which a deduction has been so completely verified when put to 
the test. 
Its success in this particular class of cases naturally suggested and even 
urged the extension of the principle to others, and it was not long before an oppor- 
tunity occurred of employing it in a case of psoas abscess, an affection from which 
at that period few adults recovered, while it was only slightly less fatal in 
children. The patient was a middle-aged woman, and the abscess, which was 
pointing in one loin, was about to burst. It was incised, and some of its thick 
contents mixed with the crude carbolic acid; two pieces of lint soaked in this 
mixture were laid over and around the wound and covered with a cap of block- 
tin. When the dressing was removed next day, there was no escape of pus as 
was usual under the treatment then customary, and pressure caused only a drop 
