354 AN ADDRESS ON 



require special attention. They should always be brushed with a nail-brush 

 before they are dried, so that there may be no crusts of dried blood upon them 

 which the carbolic lotion might require a considerable time to penetrate. If 

 this has been done, a very short period is sufficient for sterilizing. In private 

 practice I put the instruments into i in 20 carbolic lotion just before the patient 

 is brought into the room. They continue to be kept in it during the adminis- 

 tration of the anaesthetic and during our other preparations, and this is quite 

 adequate for the purpose. It is of great importance that we should not make 

 things unnecessarily complicated. 



So also with the purifying of the skin of the patient. It is not needful to 

 apply an antiseptic lotion for hours together, as is sometimes done ; a few 

 minutes' action of the i in 20 carbolic solution is really sufficient ; while its 

 long-continued operation sometimes produces troublesome irritation. For 

 purifying the eyelids before ophthalmic operations the carbolic lotion would 

 excite conjunctivitis. In this special case a weak solution of corrosive sublimate, 

 applied in compresses, is probably the best. It must, however, be continued 

 for a lengthened period. 



While carbolic acid is more trustworthy as a germicide for surgical purposes 

 than corrosive sublimate, it is in other respects also greatly to be preferred. 

 Carbolic acid has a powerful affinity for the epidermis, penetrating deeply into 

 its substance ; and it mingles with fatty materials in any proportion. Corrosive 

 sublimate solution, on the other hand, cannot be expected to penetrate in the 

 slightest degree into anything greasy ; and therefore, as the skin is greasy, 

 those who use corrosive sublimate require elaborate precautions in the way of 

 cleansing the skin — treating it with oil of turpentine or ether, not to mention 

 soap and water, to remove the grease which they feel it essential to get rid of 

 for the efficient action of the corrosive sublimate. Now all this is unnecessary 

 care if you use carbolic lotion. I can testify to this from ver}^ ample experience. 

 For my part, I do not even use soap and water. I trust to the carbolic acid, 

 which, by its penetrating power and great affinity for organic substances, purifies 

 the integument as corrosive sublimate cannot. 



Our sponges during the operation are washed with i in 40 carbolic lotion. 

 You will see how important it must be to have your nurses and assistants careful. 

 In truth, it needs no small pains to teach them to take the care, simple as it is, 

 yet all-important, that is requisite for avoiding the contamination of a wound 

 with gross septic material. Finally, because we cannot be always quite certain 

 of our assistants being as careful as we wish, before we close the wound we wash 

 it with I in 40 carbolic lotion. This irritates very much less than the spray, 

 which applied a stronger solution during the whole operation ; and in proportion 



