i68 ON A CASE ILLUSTRATING THE PRESENT ASPECT 



reports from various quarters of the efficacy of oakum, I have lately put it to 

 the test with granulating sores, where, if it should happen to fail, no mischief 

 would result, and I have found it more than answer my expectations. The 

 reason for its superiority over oily cloths is readily intelligible. Each fibre 

 of the oakum is imbued with an insoluble vehicle of the antiseptic ; so that 

 the discharge in passing among the fibres cannot wash out the agent any more 

 than it can when flowing beneath the lac-plaster, to a narrow strip of which 

 an individual oakum fibre is fairly comparable. I may remark as worthy of 

 notice by those who still cling to the idea that carbolic acid has some unknown 

 virtue distinct from its antiseptic property, that oakum contains none of that 

 substance, but creosote and probably other antiseptic hydro-carbons, the effects 

 of which in preserving smoked meat are familiar. 



Oakum not only proved efficient antiseptically, but presented several 

 advantages over lac-plaster. When the latter is left as a dressing for several 

 days together, the discharge, even though small in amount, soaking into the 

 absorbing cloths, loses the carbolic acid it had received from the plaster, and, 

 putrefying from day to day, assumes an acrid character, and sometimes pro- 

 duces most troublesome irritation of the skin. This is, of course, avoided by 

 the oakum. Again, the lac-plaster being quite impermeable to watery fluid, 

 keeps the skin beneath it moist, and, in fact, covered with a weak watery solu- 

 tion of carbolic acid, which, I suspect, insinuates itself, more or less, beneath the 

 protective, and maintains a slight stimulating influence upon the parts beneath 

 into it. But oakum, draining away the discharge as fast as it is effused, avoids 

 this source of disturbance. The result is, that if a granulating sore is thoroughly 

 washed with an antiseptic lotion and covered with ' protective ' and a well- 

 overlapping mass of oakum secured with a bandage, a dressing is provided 

 which nearly approaches the ideal I have long had in view. For, as granula- 

 tions do not form pus or even exude serum except when stimulated, a persistent 

 antiseptic, combined with an efficient protective, should constitute a more or 

 less permanent dressing under which discharge should cease and cicatrization 

 proceed with great rapidity. Accordingly, ulcers of the leg treated in this way 

 have been found, when exposed after the lapse of several days, either entirely 

 healed or greatly advanced in the process, while the moisture beneath the 

 protective has been of a serous character and the discharge collected in the 

 oakum comparatively small in amount. Lastly, the lac-plaster has this further 

 disadvantage from the moisture beneath it, that it prevents efficient strapping 

 in cases that require it. But under oakum an adhesive plaster retains its hold 

 as well as under dry lint.^ 



^ Antiseptic adhesive plaster is readily improvised by dipping ordinary strapping in a hot solution 



