THE BRITISH MEDICAL ASSOCIATION i8i 



do we occasion to the tissues of the part treated with it. The antiseptic is 

 always injurious in its own action ; a necessar}- evil, incurred to attain a greater 

 good. To suppose that it is useful by its own operation in some specific manner 

 unknown to us, is an entire mistake. I know that, not only from theory, but 

 as a matter of experience. At one time, I used the undiluted acid ; and, in 

 doing this, I could not avoid producing not merely irritation, but a certain 

 amount of sloughing. Then I used a strong solution of carbolic acid in oil ; 

 then a rather strong solution in water ; then a weaker watery lotion ; and 

 now we employ a solution as weak as that which I have described — one part 

 of carbolic acid in a hundred of water — and that applied only in the form of 

 spray, avoiding absolute drenching of the tissues at all, and avoiding also the 

 injection of the wound by a syringe, as we used to do after the operation was 

 completed, in order to destroy the organisms introduced ; and, in direct pro- 

 portion to the weakness of the solution used and to the smallness of its oppor- 

 tunity of acting on the tissues of the part, is the satisfactoriness of the results 

 obtained, provided that the essential object of avoiding putrefaction is secured. 



And now, supposing that I were, single-handed, about to change the dressing 

 in the case to which I have alluded — a large psoas abscess — the spray is of 

 extreme value. I wish that the spray shall play upon the surface of the body, 

 in the angle between the dressing and the skin, as I lift the gauze. It would 

 be very inconvenient if it were necessary' for this purpose always to have an 

 assistant to work the spray ; but, by a little management, the spray can be 

 worked perfectly w^eh, as you see, by the surgeon himself. [This is done by 

 placing the bottle of Richardson's apparatus against the ball of the thumb, 

 and holding the india-rubber bulb to be compressed between the opposite side 

 of the bottle and the fingers of the same hand.] Supposing this were the site 

 of the incision in a case of psoas abscess, as long as I choose I can perfectly 

 protect it with the antiseptic atmosphere, and then put on what we have called, 

 for the sake of distinction, a ' guard ' — a piece of rag dipped in the one to one 

 hundred watery solution of carbolic acid, after which the spray can be remo\-ed 

 with security ; the surrounding parts having then been cleansed from any 

 discharge there may be, the spray is once more made to pla}' on the part during 

 the exposure of the wound until the permanent antiseptic dressing is reapplied. 



But, gentlemen, though such a spray-producer is perfectly efficacious for 

 a small operation, it does not make a cloud of sufficient \-olume for a large one, 

 such as an amputation of the thigh or at the hip-joint. Therefore, with the 

 object of securing the same result in such cases, I have had this apparatus 

 prepared, which, I confess, is in a cumbrous and heavy form ; but 1 hope it 

 will be improved in that respect before long. Meanwhile, it is much better 



