212 ON RECENT IMPROVEMENTS IN THE 



half is then put back into position and another syringeful thrown on. The 

 same process is repeated with ah the other pieces of gauze, after which the 

 weight is put into the chamber to compress the charged cotton, and the hd 

 apphed. An hour or two are then aUowed to elapse to permit the complete 

 diffusion of the liquid, when the material is fit for use. 



The apparatus above described can be constructed by a common tinman 

 for about £io ; and it is estimated that the entire cost of the gauze to the 

 Edinburgh Infirmary, including the price of materials and manufacture, is 

 somewhat less than 2d. per square yard. For hospital purposes this expense 

 is further reduced by the fact that the gauze, after being used for dressing a case, 

 can be entirely cleansed of the substances with which it was charged by washing 

 in boiling water, care being taken to press it well in the hot water with a suitable 

 wooden implement. The cotton cloth is then even better adapted for the 

 purpose than it originally was, having lost the slight rigidity caused by the 

 starch or gum used to stiffen the threads before weaving. Thus the same piece 

 of cotton may be used over and over again, with saving to the institution of 

 the chief cost of the material, w^iich, as before said, is that of the cotton. Prac- 

 tically, however, it is only larger dressings which will repay the trouble of washing 

 and arranging in proper masses for recharging. 



Solution of carbolic acid in the fixed oils, which, as regards the tenacity 

 with which they hold the acid, occupy an intermediate place between the watery 

 solutions and the resinous mixture in the gauze, has been for the most part 

 superseded by these latter ; a watery solution being more efficient as well as 

 more cleanly for a detergent lotion, while the resinous mixture is more mild 

 and more persistent, and therefore better adapted for a permanent dressing. 

 There are, however, some circumstances in which the oily solutions are valuable. 

 For lubricating instruments introduced into the bladder, such as catheters, 

 bougies, sounds, or lithotrites, I have for some time past used a solution of one 

 part of carbolic acid in twenty parts of olive oil ^ — a proportion which, while 

 unirritating to the urethra, is trustworthy as an antiseptic ; and there can be 

 no doubt that the avoidance of putrefactive fermentation within the bladder 

 is in many cases a matter of vital importance. In using a catheter, the interior 

 of w^hich cannot be kept clean, but must have more or less of foreign material 

 encrusted upon it, some of which might by chance enter the bladder from 

 regurgitation, the instrument should either be kept for several minutes with 

 the carbolic oil within it before it is passed, or, what is more efficient and saves 



^ The practice of using carbolized oil for lubricating instruments introduced into the bladder was 

 first suggested, so far as I am aware, by Professor Rolleston, in his address on Physiology dehvered 

 at the Oxford meeting of the British Medical Association. (See British Medical Journal, August 15, 1868.) 



