AS A SURGICAL DRESSING 297 



agent had ever been ascertained to possess in anything Hke such dilute solutions. 

 With regard to our purposes in antiseptic surgery, the inhibitory action of the 

 antiseptic would be sufficient, provided we be satisfied that our wound is left 

 free from injurious organisms, and that the dressing which we apply itself 

 contains no such organisms still alive. Then, all we require is that the dressing 

 should be able to prevent the development of organisms from without into the 

 discharges with which the dressing may be soaked. That is obvious. 



Corrosive sublimate has been used extensively already by our German 

 brethren, chiefly in the form of sublimate wood-wool, as it is called, in which 

 one-half per cent, of corrosive sublimate, with an equal part of glycerine, is 

 mixed with what is termed ' wood-wool ', namely, pine-wood reduced almost 

 to a state of powder by suitable machinery. This is highly absorbent. It is 

 employed in large masses, and, so used, has given many excellent results. At 

 the same time, it is somewhat unwieldy in its application. Under certain 

 circumstances, it is not convenient to have so large a mass as is essential for 

 its safety, and we have also varying reports as to its efficacy ; and I may remark 

 that we find some surgeons satisfied with what others would regard as a very 

 mediocre kind of success with antiseptic treatment. 



The circumstances to which I referred at the beginning of my address 

 naturally made me turn my attention to corrosive sublimate ; and I was desirous, 

 if possible, to use it in a more concentrated form, so that it might be employed 

 in a less bulky fashion. Accordingly, I prepared a gauze containing, instead 

 of one-half per cent., one per cent, of the sublimate. 



The first case in which I used it was that of an elderly lady, from whom 

 I removed the mamma and cleared out the axillary glands. I put immediately 

 over the wound a piece of prepared oiled silk, which I dipped in a i to 500 solution 

 of corrosive sublimate ; then, over this, sublimate gauze, and outside all an 

 abundant eucalyptus dressing. On the following day, when we changed the 

 dressing, I found that, under the oiled silk, exactly corresponding to its extent, 

 the skin was highly irritated, and was covered with small vesicles. I also found 

 that the inner side of the arm, where there was no wound, was in the same 

 state of intense irritation. I covered the irritated parts of the inner side of the 

 arm with eucalyptus gauze, dipped in a weak solution of carbolic acid, and 

 I applied to the wound the i per cent, sublimate gauze without any intervening 

 protective oiled silk. On the following day, I found that the little vesicular 

 pustules, which had formed the first day under the protective, had healed, and 

 that the inner side of tlie arm also had recovered from its irritation. TIow were 

 these facts to be explained ? I believe the explanation to be this. The i to 500 

 watery solution of corrosive sublimate, prevented by the oiled silk from escaping, 



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