MEMBERS OF THE BRITISH MEDICAL ASSOCIATION 261 



round my wards some time since, expressed astonishment that I should use 

 dirty lotion to wash a wound, and to purify what I was placing upon it ; but. 

 Gentlemen, the wound, although aesthetically dirty, was surgically pure, and 

 the lotion had not been made impure by being used for washing it. E\-en if 

 it had been otherwise, we might have trusted the carbolic acid to purifv it. 

 Why then should we waste good lotion ? I di]^, therefore, in the lotion this 

 piece of gauze that I place next to the wound, and thus make perfectly sure 

 that nothing septic is applied to it. 



It is most important that the spray be properly directed during the dressing. 

 I have seen a surgeon expose a serious wound, involving injury to the brain, 

 while the spray was only playing on the opposite side of the head. It were 

 far better that the antiseptic method should not be employed at all than that 

 it should be used imperfectly. For such attempts not only end in disappoint- 

 ment, but throw discredit on the system. Some people seem to say, ' I have 

 tried the thing and failed, and therefore, of course, the system is all nonsense.' 

 I have seen it fail in my own practice, but under such circumstances I have 

 always thought there must have been some mistake on my part, and I have 

 endeavoured to discover where my mistake lay. But that does not seem to be 

 the way in which the matter is viewed by some of our professional brethren. 



A small piece of gauze dipped in the lotion having been placed next the 

 wound, the dressing on which we rely for excluding putrefaction is applied in 

 the form of eight layers of the gauze, sufficiently broad, as you see, to cover the 

 surrounding skin for several inches in every direction ; and beneath the outer- 

 most layer is placed this piece of thin macintosh cloth to prevent the discharge 

 from going directly through the dressing ; because, if a considerable quantity 

 went through, strongly as the resin holds carbolic acid, it might be all washed 

 out before twenty-four hours had elapsed, and then putrefaction would spread 

 inwards to the wound. The dressing is secured by a bandage, for which strips 

 of the antiseptic gauze prove very convenient. Now, Gentlemen, we are per- 

 fectly sure that, if we have left nothing septic in the wound, we shall tind no 

 putrefaction when the dressing is changed to-morrow. 



[The subsequent progress of this case has illustrated well the remarks made 

 at the demonstration, with regard to the effects of a free opening, or the contrary, 

 under antiseptic management. When I saw the patient on the following day, 

 I learned that he suffered unusual pain in the afternoon after the ojxM-ation. 

 which became very severe during the night, and though somewhat less in degree 

 at the time of my visit, was still very considerable. The temperature had 

 risen on the previous evening to 102-4° Fahr., and was now ioi-8°. Such 

 a state of things would at one time have alarmed me, and would have made 



