298 AN ADDRESS ON CORROSIVE SUBLIMATE 



had acted as a powerful irritant upon the skin ; but when the i per cent, gauze 

 was apphed directly to the wound, the oozing of albuminous discharge from 

 the pustules and from the edges of the wound mitigated the action of the corrosive 

 sublimate, and so prevented further irritation there. Again, in the case of the 

 arm, what had occurred was, free perspiration had taken place, and the per- 

 spiration forming, with the corrosive sublimate in the gauze, a watery solution, 

 had produced irritation where the perspiration was, on the same principle as 

 the watery solution had caused irritation under the protective. 



I continued to use a corrosive sublimate dressing in this case. It so happened 

 that there was a very free haemorrhage after the operation. I never before 

 saw small vessels so atheromatous. We had to tie multitudes of little rigid 

 arteries, and, in spite of this, a considerable effusion of blood took place, and 

 bagged under the skin. She left town with the outer angle of the wound still 

 unhealed, and having the remains of the blood-clot exposed in it — the dressing 

 employed being a piece of absorbent cotton- wool charged with about five per cent, 

 of sublimate, secured in its place with collodion — and she came every few days 

 to London to have the dressing changed. On these occasions I found that, 

 although the serous discharge had soaked the wool more or less, there was no 

 irritation caused by it ; and the blood-clot, in course of time, presented an 

 appearance which I never happen to have seen before. From the epidermic 

 edges of the little wound, the epidermis crept over the surface of the blood-clot 

 like the white claws of an animal, extending over the dark coagulum. We are 

 familiar with the organization of the coagulum in exposed wounds, and we are 

 also familiar with the fact that in the course of time the superficial clot may be 

 removed, and a scar found under it, without any suppuration having taken 

 place, or any granulation, strictly speaking ; but I never happened to have 

 seen before this formation of epidermis extending over the surface of an exposed 

 coagulum ; and the explanation I believe to be that, while the sublimate wool 

 rendered the wound, for surgical purposes, perfectly aseptic, the albuminous 

 discharge from the wound prevented the sublimate from coming into operation 

 as an irritant, and so we had, in a peculiarly perfect manner, complied with the 

 essential conditions for the treatment of superficial sores — namely, the exclusion 

 on the one hand of septic agency, and on the other of the irritating property 

 of our dressing. I may add that the wound healed without a particle of pus 

 having been formed from first to last. 



While this case showed that in the sublimate we had an agent that might 

 give very beautiful results, it also indicated that we were dealing with an edged 

 tool, which, while it might do admirable work, was very apt also to cut our 

 fingers ; and the question suggested itself, Was it, after all, possible to use 



