AS A SURGICAL DRESSING 307 



hours, but very little blood escaped externally, because this gauze absorbs very 

 much better than our carbolic-acid or eucalyptus gauzes do, containing as they 

 do resin and paraffin ; and I would strongly recommend that, during the first 

 twenty-four hours, this gauze should be used in at least sixteen layers. It is 

 now three days since the operation was performed, and, from the perfectly 

 normal temperature and returning appetite and strength, I think we mav be 

 satisfied that the boy is already out of risk of septic complications. And this 

 you will observe, is a very testing case. 



I may mention one other case, that of a boy six years old, from whom, 

 nearly three weeks ago, I removed a portion of a rib, for the purpose of allowing 

 free drainage to empyema. We let out thirty ounces of thick, odourless pus, 

 and a great quantity came out afterwards. He has been dressed with sero- 

 sublimate gauze ; and he is one of the instances in which gauze prepared with 

 the I to 50 serum caused irritation, which disappeared under the i to 100. 



In him we have witnessed the beautiful course which, I believe, we can 

 only see under antiseptic treatment efficiently managed, of no more pus formed 

 after the first pus has been evacuated — nothing but a serous oozing rapidly 

 diminishing ; and I was delighted to see, on coming back after a fortnight's 

 absence, how^ plump the emaciated little fellow had become. And the serous 

 discharge is now so slight, that I believe it would be already safe to remove 

 the drainage-tube. This case, I think, proves that our dressing is aseptic, 

 that the germicidal properties of the corrosive sublimate have come into play 

 in the preparation of the dressing, so that any injurious organisms which existed 

 in the blood or in the gauze before they were brought into preparation, have 

 been destroyed : because, if there had been merel}- the inhibitory influence 

 of the sublimate upon the organisms, the serum pouring out from the pleura, 

 washing away all the antiseptic in the vicinity of the wound, but leaving the 

 organisms lodging amiong the fibres, then we should have had putrefaction, or 

 other disturbing causes, showing themselves. No such thing having occurred, 

 this case seems of itself sufficient evidence that our dressing: is realh' a safe one 

 in so far that it contains no living organisms of importance to start with. 



I have here a sample of a very cheap fibre, sent me from the south of France, 

 prepared with this sublimate-serum, and then teased out, showing that we may 

 use this material for charging various fabrics. This fibre is highly absorbent ; 

 and I may remark that, if we have a very highh' absorbent drcssini:. wo may, 

 and must, use a larger proportion of the sublimate. A gauze will absorb only 

 about three times its weight of liquid ; cotton-wool will absorb ten times its 

 weight ; and therefore you observe, when the one dressing is saturated, it has 

 three times as much of the liquid in it, and thus has the sublimate three 



