x] INTRODUCTION 
managed. Pressure forceps, the use of which makes it possible to stanch by 
a few minutes’ pressure, and, if thought necessary, to tie all bleeding-points, had 
not yet been introduced. Moreover, the stimulation of the wound by the anti- 
septic fluid, even though the endeavour was made to reduce this to a minimum, 
increased the flow of serum. To prevent the accumulation of these discharges, 
Lister had been in the habit of introducing and retaining for at least forty-eight 
hours, at one angle of the wound, a strip of lint soaked in a solution of carbolic 
acid and oil (1 to 4). The substitution of india-rubber drainage-tubes proved 
a valuable improvement in antiseptic technique. They were, of course, kept 
constantly immersed before use in a strong solution of carbolic acid. 
Holding the view that the dust floating in the air was a potent source of 
infection, but recognising that the contact of carbolic lotion with the wound 
during the operation and at subsequent dressings was a source of irritation, Lister 
at about this period introduced the use of a spray of carbolic acid solution to play 
around the wound, with the view of destroying the germs floating in the air before 
they settled on the wound. He, however, eventually convinced himself, firstly; 
that the spray did not thoroughly disinfect the atmospheric dust, and secondly, 
that not only were the microbes in the air for the most part not pathogenic, but 
also that the tissues were capable of destroying organisms, provided they were 
neither very numerous nor very virulent. After full consideration of all the 
facts, and especially those constantly observed in the treatment of empyema,} 
Lister abandoned the use of the spray without reverting to the other precautions 
against the atmospheric infection which had formerly been deemed, and perhaps 
then were, essential. 
Although carbolic acid had proved so conspicuously satisfactory as an 
antiseptic for use in surgery, it was open to two objections. The first was that 
it was irritating to the wound, and must therefore to some extent retard healing, 
and was poisonous if absorbed in quantity; the second, that, being volatile, 
it was constantly being dissipated from the dressings, which it was therefore 
deemed advisable to change oftener than would otherwise have been necessary. 
Lister, consequently, was always seeking to find some substance which, while 
possessing adequate antiseptic properties, would yet be unirritating, non- 
poisonous, and non-volatile. 
Among a large number of substances which were tested in practice, the 
tollowing may be mentioned. In consequence of reports as to the value of 
boracic acid for the preservation of food, this substance was very extensively 
tried ; it was, however, found to be quite inefficient as an antiseptic for ordinary 
practice, but it did very well in the case of superficial sores and ulcers, and for 
’ Address to International Medical Congress, Berlin, 1890. Reprinted in vol. li, p. 332. 
