i8o THE ADDRESS IN SURGERY DELIVERED BEFORE 



do not tend to slip as those of a cotton-bandage do, which is an additional 

 advantage. 



Such, then, are the means by which, in ordinary cases, we ensure that 

 putrefactive fermentation does not extend from \\athout into the wound or 

 abscess. Of course it would be of no use to apply such an external dressing 

 if putrefactive particles in an active state were left within a wound. If a wound 

 be presented for treatment, having been inflicted by another than the surgeon, 

 some dust is sure to have been introduced ; and we must first destroy its septic 

 energy by washing the raw surface thoroughl}^ with some liquid trustworthy 

 for the purpose, such as chlorine-water, or sulphurous-acid lotion, or a strong 

 solution of carbolic acid, or of chloride of aluminium, for there are various pre- 

 parations which may be used with efficiency. But when the surgeon operates 

 on a previously unbroken integument, he has the opportunity of preventing 

 the septic particles from entering in an active state at all, by operating in an 

 antiseptic atmosphere. This is readily provided for in small operations by 

 using a w^atery solution of carbolic acid with Richardson's apparatus for local 

 anaesthesia. For making the spray more fine, I have found it convenient to 

 have the lower end of the w^ater-tube almost entirely stopped up, leaving only 

 ver}^ minute apertures. The result is, as you see, an exceedingly satisfactory 

 spray. For any small operation this answers the purpose perfectly well, 

 provided always that you take the precaution of having the liquid filtered 

 through a cambric handkerchief or some similar fabric, in order to exclude 

 the grosser particles of dust, which otherwise would have the effect of blocking 

 up the fine orifice at the nozzle of the apparatus — an occurrence which, under 

 some circumstances, might be disastrous in its effect. 



We have lately found that the strength of the solution employed for pro- 

 ducing the spray may be considerably reduced. We have ascertained that it 

 may be used as weak as one part of carbolic acid to a hundred parts of water ; 

 and that a spray made with such a lotion is thoroughly trustworthy as an 

 antiseptic atmosphere. 



The reduction of the strength of the spray is a matter of great importance. 

 In the first place, it is a great comfort to the surgeon, as I can testify from 

 experience. When we used a solution as strong as one part of carbolic acid 

 to forty parts of water, my hands w^ere constantly in a rough and uncomfortable 

 state ; but when the proportion is reduced to one to a hundred for the produc- 

 tion of the spray, the hands experience no inconvenience whatever, and one 

 can even breathe with comfort in such an atmosphere. 



In the second place, it is equally advantageous for the patient, because 

 the weaker the antiseptic application, of whatever sort it is, the less irritation 



