ILLUSTRATING THE ANTISEPTIC SYSTEM OF TREATMENT 145 



the application. You will bear in mind that the protective is not designed 

 to have any persistent antiseptic virtue ; and that, like the wound at 

 the first dressing, it must be freely overlapped at every point by the antiseptic 

 plaster. 



These principles will be found to apply whatever be the materials used 

 for carrying out the antiseptic system. An antiseptic to exclude putrefaction, 

 with a protective to exclude the antiseptic, will hy their joint action keep the wound 

 free from abnormal stimulus. 



Though we have not yet got a perfect protective, that which we are now 

 generally using answers very fairly, and has this advantage — that the materials 

 for it can be obtained from any druggist's shop. The basis of it is the common 

 oiled silk. I am indebted to my late house surgeon, Dr. Joseph Coats, now 

 Pathologist to the Glasgow Royal Infirmary, for calling my attention to the 

 fact that carbolic acid does not pass nearly so readily through oiled silk as through 

 gutta-percha. But if oiled silk is dipped into a carbolic lotion before applying 

 it, the watery fluid runs from the surface as from a duck's back, and there is 

 risk of septic particles being depositied upon the dry parts, even during the 

 rapid transfer from the vessel containing the lotion to the wound. I had reason 

 to suspect that, in some cases of hollow wounds, putrefaction was actualh' 

 brought about from this cause ; and hence I was induced to abandon the oiled 

 silk for a while. But of late I have had it coated with a soluble film, which 

 entirely removes this objection. The oiled silk is brushed over with a mixture 

 of one part of dextrine, two parts of powdered starch, and sixteen parts of 

 cold watery solution of carbohc acid (i to 20). The carbolic-acid solution is 

 used rather than water, not for its antiseptic property, but because it makes 

 the dextrine apply itself more readily to the oiled silk, and the granular starch 

 is used for a similar purpose. The carbolic acid may be afterwards allowed to 

 fly off without disadvantage ; so that there is no need for keeping the pro- 

 tective, like the antiseptic plaster, in a close vessel. Oiled silk thus prepared 

 becomes uniformly moistened when dipped in a watery solution of the acid, so 

 that all risk of communicating putrefactive mischief along with it is a\'oided ; 

 and if it be used in two layers it opposes a pretty effectual barrier to carbolic 

 acid, as is sufficiently illustrated by the progress of the present case. 



On the day after the accident the cloths around the lac-plaster applied to 

 the ankle, and even the pasteboard spHnt and its padding, were found soaked 

 with bloody discharge. On the second day, when the dressings were again 

 changed, the cloths presented only a stain corresponding to a few drachms of 

 tinged serum ; so that I thought it safe to allow two days to pass before the 

 next dressing. I believe it to be best in all cases to change everything on the 



