i6o FURTHER EVIDENCE ON ANTISEPTIC SYSTEM OF TREATMENT 



referring. One of them was a man above the middle period of hfe, in whom 

 I had performed amputation at the knee-joint. Five days after the operation, 

 the discharge amounting to only a few minims of serum in the twenty-four 

 hours, and the patient being free from constitutional symptoms, I thought him 

 a favourable subject for illustrating the antiseptic dressing of a stump before 

 the clinical class. Accordingly I had him taken into the theatre, and dressed 

 him there ; and, not thinking how time was passing, I left the stump covered 

 only with a piece of calico soaked with cold watery solution of carbolic acid 

 while I discussed at considerable length the mode of procedure. It happened 

 to be one of the coldest days of that severe winter, and it afterwards occurred 

 to me that I had been guilty of imprudence in exposing the stump so long. 

 Next day he complained of not feeling so well, and the skin near the wound 

 exhibited the commencement of an erysipelatous blush, which spread some 

 distance up the trunk before it finally subsided. The other case was one of 

 removal of the mamma for scirrhus. In changing the dressings the exposed 

 surface of the chest was syringed with the cold watery solution of carbolic acid, 

 and, in that very cold weather, a chill was certainly not unlikely to occur from 

 such treatment. Here also a blush of redness appeared near the wound, and, 

 though it was only superficial and did not spread far, it was unmistakably 

 erysipelatous. Taking this view of the cause of the complaint in these two 

 cases, I adopted the simple expedient of making the i to 40 watery solution 

 of carbolic acid by mixing that of the strength i to 20 with an equal quantity 

 of hot water, so as to make a warm lotion ; and during the seven months in which 

 this plan has been pursued we have had no more appearance of erysipelas. 



Thus my wards, although by no means models, as regards their principle 

 of construction or the space allowed between the beds, appear perfectly free 

 from any liability to hospital diseases. 



Edinburgh, July 22, 1870. 



