4 ON A NEW METHOD OF TREATING 



exercises a local sedative influence upon the sensory nerves ; and hence is not 

 only almost painless in its immediate action on a raw surface, but speedily 

 renders a wound previously painful entirely free from uneasiness. When 

 employed in compound fracture its caustic properties are mitigated so as to 

 be unobjectionable by admixture with the blood, with which it forms a tena- 

 cious mass that hardens into a dense crust, which long retains its antiseptic 

 virtue, and has also other advantages, as will appear from the following cases, 

 which I will relate in the order of their occurrence, premising that, as the treat- 

 ment has been gradually improved, the earlier ones are not to be taken as 

 patterns. 



Case i. — James G , aged eleven years, was admitted into the Glasgow 



Royal Infirmary on the 12th of August, 1865, with compound fracture of the left 

 leg, caused by the wheel of an empty cart passing over the limb a little below 

 its middle. The wound, which was about an inch and a half long, and three- 

 quarters of an inch broad, was close to, but not exactly over, the line of fracture 

 of the tibia. A probe, however, could be passed beneath the integument over 

 the seat of fracture and for some inches beyond it. Very little blood had been 

 extravasated into the tissues. 



My house surgeon. Dr. Macfee, acting under my instructions, laid a piece 

 of lint dipped in liquid carbolic acid upon the wound, and applied lateral paste- 

 board splints padded with cotton wool, the limb resting on its outer side, with 

 the knee bent. It was left undisturbed for four days, when, the boy com- 

 plaining of some uneasiness, I removed the inner splint and examined the wound. 

 It showed no signs of suppuration, but the skin in its immediate vicinity had 

 a slight blush of redness. I now dressed the sore with lint soaked with water 

 having a small proportion of carbolic acid diffused through it ; and this was 

 continued for five days, during which the uneasiness and the redness of the 

 skin disappeared, the sore meanwhile furnishing no pus, although some super- 

 ficial sloughs caused by the acid were separating. But the epidermis being 

 excoriated by this dressing, I substituted for it a solution of one part of carbolic 

 acid in from ten to twenty parts of olive oil, which was used for four da3^s, during 

 which a small amount of imperfect pus was produced from the surface of the 

 sore, but not a drop appeared from beneath the skin. It was now clear that 

 there was no longer any danger of deep-seated suppuration, and simple water 

 dressing was employed. Cicatrization proceeded just as in an ordinary granu- 



kind in compound fracture, it would probably be better to use the crystallized form, melting it by 

 placing the vessel containing it in warm water for a few minutes. Carbolic acid is almost absolutely 

 insoluble in water, but dissolves readily in various organic liquids, such as the common fixed oils 

 or glycerine. 



