THE BRITISH MEDICAL ASSOCIATION 179 



of our principal means and methods of treatment. For preventing the access 

 of putrefactive fermentation, the agent which we now commonly use is what 

 we have termed the antiseptic gauze, of which these are samples — being a loose 

 cotton fabric, the fibres of which are impregnated with carbolic acid securely 

 lodged in insoluble resin, which holds the carbolic acid with remarkable tenacity, 

 while at the same time a little paraffin is added to prevent the adhesiveness 

 which the mixture of carbolic acid and resin would otherwise possess. The 

 interstices between the fibres are kept free from these ingredients, so that the 

 fabric, being porous, may be fitted for absorbing discharges. The carbolic 

 acid is in considerable quantity in the gauze ; but it is held so tenaciously by 

 the resin that, on the one hand, when first applied, it is unirritating to the human 

 skin, and, on the other hand, unless discharge be very copious, it will retain 

 its virtues for upwards of a week at the temperature of the human body. Now 

 supposing I were going to use this gauze for dressing any case in which a copious 

 discharge was expected — as, for example, a large psoas abscess immediately 

 after it had been opened — I should take a considerable quantity of the gauze 

 (about as much as one can conveniently hold between the extended hands) 

 and fold it three times so as to make it eight layers. But there would be no 

 use in my having the folded gauze of this extent, if I did not adopt some means 

 for compelling the discharge to pass throughout the length and breadth of the 

 dressing ; and for this purpose some impermeable tissue must be interposed 

 between it and the external air. That which we have found the most con- 

 venient is a cheap and light form of macintosh, termed ' hat-lining ' by the 

 india-rubber dealers. I cut a piece of this, nearly as large as the folded gauze, 

 and then place it beneath the layer that is intended to be outward. The 

 discharge then coming from the wound, situated opposite the middle of the 

 gauze, instead of passing directly outwards through it, is compelled to traverse 

 all the extent of the antiseptic dressing ; and in that way, by using a sufticiently 

 large piece, and with this arrangement of the macintosh, you may be perfectly 

 certain that, if you leave no putrefactive mischief in a wound or abscess, none 

 will enter it, however profuse the discharge may be during the first twenty-four 

 hours. That is one very important point gained. As the discharge diminishes. 

 the intervals between the dressings are extended ; and when it amount> to 

 only a minim or two in twenty-four hours, the application may be left undis- 

 turbed for a week. The gauze is also extremely convenient in the form of 

 bandage — an antiseptic bandage — which is put on to hold the main dressing 

 in position ; and instead of being a nidus for putrefaction, as a cotton- 

 bandage would be, it increases at every turn the antiseptic efficacy of the 

 dressing. Besides this, the bandage having a degree of stickiness, its turns 



