68 ON THE ANTISEPTIC SYSTEM 



or to become soon dissipated into the atmosphere. Hence an oily solution is com- 

 paratively bland but permanent in its operation. These are just the properties 

 which are desirable for an external application. We wish it to serve as a reser- 

 voir of the acid, retaining it for twenty-four hours at least, so that it may remain 

 constantly exerting its antiseptic influence upon the discharges that flow out 

 beneath it. At the same time it is most important that it should be mild in 

 its action on the surface to which it is applied, in order to avoid irritation and 

 excoriation. It appears clear, therefore, that a watery solution is best adapted 

 for the treatment of the interior of a wound in the first instance, while an oily 

 preparation is suited for an external dressing. 



We have next to consider the best form for the oily application. I have 

 used various forms ; of which some have proved trustworthy, and others not 

 so. One that has shown itself thoroughly reliable is a paste composed, like 

 glazier's putty, of boiled linseed oil and whitening, but with the addition of 

 about one part of carbolic acid to four of the oil. Even in the case of large 

 abscesses, where there has been in the first instance a profuse discharge, the 

 putty, if properly applied and retained securely in position, prevents with perfect 

 certainty the spread of putrefaction into the interior. But the putty is a some- 

 what clumsy and inconvenient preparation, and I have been desirous, if possible, 

 to get rid of it. Within the last few months I have given a full trial to cloths 

 dipped in a solution of carbolic acid in olive oil, but I am sorry to say that this 

 method, though attractive from its simplicity, is not reliable. It is true, indeed, 

 that we have had some beautiful cases under this mode of management ; as 

 for example the following. 



Case of Compound Fracture of the Right Leg and Severe Contused Wound 

 in the Left Foot, in a Person of Advanced Age. — On the 31st of January last, 

 a woman, aged seventy-four years, was admitted into the infirmary, having 

 been run over by a heavily laden omnibus. The wheels had passed over both 

 lower limbs, producing in the right leg compound fracture of both bones a little 

 above the ankle, with a considerable wound on the outer side of the limb com- 

 municating with the broken fibula, and another on the opposite aspect, not 

 directly connected with the seat of fracture. In the left limb the violence had 

 been sustained by the foot, which presented at its inner aspect a large gaping 

 contused wound, four inches long and two inches broad, while the skin was 

 extensively detached, so that when a watery solution of carbolic acid had been 

 introduced at the wound, pressure over the skin at the outer or opposite side 

 caused some of the fluid to escape, showing that it had passed freely over the 

 upper surface of the foot, beneath the undermined integument. She had also 

 a wound on the forehead, two inches long, exposing the os frontis. From these 



