84 ON THE ANTISEPTIC SYSTEM 



employed the saturated watery solution in all the numerous cases of compound 

 fracture that have since come under my care, and in no instance has it failed. 

 If it answers equally well, it is obviously superior to the strong acid, since it 

 does not produce the slightest sloughing from caustic action, and, being a less 

 powerful irritant, causes a less copious serous effusion. Besides, it may be 

 injected and diffused among the tissues which are the seat of extravasation 

 with a freedom which could not be used with the acid of full strength, and it is 

 to this circumstance that I am disposed to attribute the fact that we have 

 obtained success at a period after the infliction of the injury which I should 

 formerly have thought quite hopeless, in one case, for example, as late as thirty- 

 six hours after the accident. Lastly, we avoid a disagreeable symptom which 

 we used to observe occasionally after applying the undiluted acid freely to large 

 wounds, viz. obstinate vomiting for about twenty-four hours, occasioned, no 

 doubt, by imbibition of a poisonous dose into the circulation.^ 



Catgut, manufactured from the small intestine of the sheep,^ may be had 

 at a very low price, from the thickness of a horsehair upwards. In the dry state, 

 it is somewhat objectionable from its rigidity, and also from a tendency of the 

 first half of the knot to slip before the second half is secured. Water renders 

 it perfectly supple, and as little liable to slip as waxed silk. But if a watery 

 solution of carbolic acid be used for the purpose of making it antiseptic, the 

 protracted immersion requisite to ensure completeness of the effect makes the 

 finer kinds too weak, and the stouter too clumsy so that it will not enter the 

 eye of an ordinary aneurysm-needle. The method which I have found to answer 

 best is to keep the catgut steeping in a solution of carbolic acid in five parts of 

 olive oil, with a very small quantity of water diffused through it. A larger 

 proportion of the acid would impair the tenacity of the thread. If a mere oily 

 solution be employed, the gut remains rigid, the oil not entering at all into its 

 substance. But a very small quantity of water, such as the acid enables the oil 

 to dissolve, renders the gut supple, without making it materially weaker or 

 thicker. And, curiously enough, the presence of this small amount of water 

 in the oily solution gradually brings about a change in the gut, indicated by 

 a deep brown colour, after which it may be placed in a watery solution for a long 

 time, without swelling as a portion prepared in a simple oily solution does. 

 This is a great convenience. For an oily solution is unpleasant to work with 



^ A report of the case of ligature of the external iliac artery mentioned in the footnote to p. 65, 

 together with an account of the conditions found post mortem, as also a report of the ligature of the 

 carotid artery in the calf are omitted in this place since they are given more conveniently at pp. 88-98 

 of this volume. 



* I need hardly remark that catgut is of a totally different nature from the so-called silkworm gut, 

 which is in reality unspun silk. [The reader may consult also pp. 107-8.] 



