OF THE ANTISEPTIC TREATMENT IN SURGERY 169 



But while oakum has these great advantages, it is disagreeable to many 

 persons from its strong tarry smell ; and I have been lately endeavouring to 

 apply the oakum principle in some shape free from this objection. Oakum 

 consists of the detached fibres of old ropes which had been treated with Stock- 

 holm tar, among the constituents of which is common resin. I happened to 

 notice, several years ago, that resin holds carbolic acid with remarkable tenacitv, 

 so that if one part of the latter be mixed by melting with five of the former, 

 the glutinous mixture which results on cooling communicates only a slight 

 warm taste to the tongue, though containing so large a proportion of the pungent 

 antiseptic. But this material is of itself too sticky for the purpose, and resin 

 is, besides, somewhat irritating to delicate skins. Paraffin, another constituent 

 of tar, is remarkable for its entire absence of adhesiveness, as well as for its 

 perfect blandness ; but when pure, though it may be mingled with carbolic 

 acid in the melted state, it separates entirely on cooling. If, however, the 

 three ingredients be melted together, the resin, though intimately blending 

 with the paraffin, still retains its hold upon the acid after cooling, and by a 

 proper proportion between them, a product is obtained which, while inter- 

 mediate in physical properties between the glutinous resin and the powdery 

 paraffin, is unirritating to the most sensitive skin and highly retentive of the 

 acid, while almost destitute of odour. ^ 



Cheap muslin gauze dipped in the melted mass, and well wrung or pressed 

 while hot, is an elegant and convenient form of modified oakum. It should 

 be folded into about eight layers ; and in order to prevent the discharge 

 from soaking too directly through it, a piece of thin gutta-percha tissue may 

 be placed beneath the outer layer to guide the fluid towards the edge of the 

 cloth. 



Such was the dressing employed a week after the operation. Three days 

 later, the wounds were found still healing rapidly without suppuration, and, 

 on rotation of the hand, the end of the radius was felt moving in its proper 

 place, while the ulna presented a slight convexity backwards, instead of its old 

 concavity. The patient who had been till then confined for the most part 



of carbolic acid made by mixing one part of i to 20 lotion with about two parts of boiling water. When 

 used in this way, strapping will adhere to a moist skin, so that it may be apphed under the spray when 

 circumstances render this desirable. 



' The proportions which I have hitherto found to work best are. sixteen parts of paraffin, four 

 parts of resin, and one part of crystallized carbolic acid. I am far from supposing that this first attempt 

 at improving upon oakum affords the best result attainable ; and I propose to institute experiments 

 with various other constituents of tar. But it seems worth while to mention the result already arrived 

 at, because, while it certainly works wrll in practice, its constituents are obtainable where lac-plaster 

 may not be so. It has the further advantage of being a very economical dressing. For the gauze loses 

 the paraffin and resin entirely when washed in boiling water, so that it may be used over and over again, 

 while about a halfpenny covers the expense of the ingredients required to charge a square yard. 



LISTER II N 



