70 ON THE ANTISEPTIC SYSTEM 



before sufficient time had elapsed for granulation and suppuration to take place 

 under the stimulating influence of the antiseptic, became a perfectly unirritating 

 or neutral body, and the dead portion of tissue beneath it, being in like manner 

 destitute of any stimulating properties, became amenable to absorption, like 

 the bit of the external coat in the noose of the antiseptic ligature, or the dead 

 bone in the case of necrosis, above related. 



But, while I have mentioned this case as a good example of the behaviour 

 of severe injuries under antiseptic management, I wish it to be distinctly under- 

 stood that I do not recommend the mode of dressing adopted. For, as I have 

 already stated, and as bitter experience in some other cases has but too clearly 

 convinced me, it cannot be implicitly relied on. The reason why it is less trust- 

 worthy than the putty is sufficiently plain. The lint, being porous, absorbs the 

 discharge, which, as it enters, displaces the antiseptic oil, and may thus, if 

 profuse, establish a channel of putrescible materials from the external atmo- 

 sphere to the wound. Again, when the discharge has passed through the dress- 

 ing, even though it have been imbued with carbolic acid in its passage, it gives 

 it off into the atmosphere on exposure, when it becomes again liable to putre- 

 faction, and, having putrefied, may soak back into the porous dressing, and 

 deprive it entirely of antiseptic virtue. For carbolic acid and the products of 

 putrefaction exert a powerful chemical action upon each other ; and, on this 

 account, the former is a deodorant as well as an antiseptic, and, conversely, 

 the latter, if in sufficient quantity, neutralize the acid and render it inert. In 

 this way, I have known a dressing, consisting of several layers of the oiled lint, 

 lose all odour of carbolic acid and acquire that of decomposition within twenty- 

 four hours of its application.^ The putty, on the other hand, being impermeable 

 to the discharge, retains the carbolic acid securely stored up, except in so far 

 as it is exhaled from the surface, to maintain a constant antiseptic action upon 

 the blood, serum, or pus that flows out beneath. 



Impermeability to a watery fluid being thus evidently the essential cause 

 of the superior efficacy of the putty, the chalk, which is its chief constituent, 

 being of no other use than to give consistency to the mass, it naturally occurred 

 to me that, if the oily vehicle of the carbohc acid were in a sohd form, the chalk 

 might be dispensed with, and the advantages of the putty might be obtained 

 in a less bulky and more convenient form. I tried, in the first place, various 



^ If fresh oil is assiduously supplied at short intervals by night as well as by day, this objection 

 to oily cloths as a dressing is removed. But this would in many cases be impracticable ; and, as a 

 general rule, it is obviously undesirable, from the trouble and uncleanhness involved in it. There are 

 situations, however — such as the perineum — in which this is probably the best mode of management. 

 And it may be added that, in any case where the discharge is very trifling, oiled lint, changed once in 

 twenty-four hours, will prove sufficiently rehable. 



