THE ANTISEPTIC MANAGEMENT OF WOUNDS 363 



absorbent gauze at your disposal, linen rags, which are excellent in absorbing 

 quality, may be quite well charged in a similar manner. This old towel which 

 has been so prepared, if folded a few times, would make a perfectly satisfactory 

 dressing. Bandages which it is desirable to render efficiently antiseptic, such 

 as one that is to be applied next the skin for keeping down the soft parts in 

 a stump after amputation of the thigh, may be charged on the same principle. 



When a free discharge is anticipated we apply a piece of thin macintosh, 

 sponged with carbolic lotion, over the exterior of the dressing, to prevent the 

 blood and serum from passing directly through it. This arrangement no doubt 

 interferes somewhat with the inspissation of the discharges by evaporation, 

 but this is a matter of indifference when the dressings are efficiently antiseptic. 



There is another use to which the dyed cyanide powder may be often advan- 

 tageously put, namety, treating it with enough of the i to 20 carbolic lotion to 

 make a sort of soft mud or cream which may be applied with a camel' s-hair brush 

 to parts where there is very little space between the wound and some source 

 of septic contamination. I have by this means been repeatedly able to avoid 

 suppuration in the vicinity of the anus, as I otherwise might have failed to do. 

 The store of the antiseptic salt upon the skin prevents the microbes from working 

 their way into the wound under the narrow strip of dressing alone available. 

 There are also situations, such as the pubes, where the cyanide cream applied 

 to the hairs converts them with great advantage into a part of the antiseptic 

 dressing. 



I may be asked how it was that I obtained uniformly good results when 

 I used corrosive sublimate solution for the purpose of producing a germicidal 

 effect upon the gauze ; for I do not exaggerate when I say that during nearly 

 two years in which I followed this practice I did not meet with a septic failure 

 when I had an unbroken skin to deal with and a fair held around for the dressing. 

 This success was no doubt partly due to the slight solubility of the double salt 

 preventing it from being washed out of the deeper parts of the gauze. But 

 I attribute it also to another circumstance. I invariably washed a substantial 

 mass of the gauze which was to be applied next the wound in i to 20 carbolic 

 lotion, in order to get rid of the irritating bichloride which it contained. I thus — 

 though unintentionally — effectually sterilized, not only this portion of the gauze, 

 but also neighbouring parts into which the redundant carbolic liquid soaked. 

 And this mode of procedure, though not so perfect as the systematic moistening 

 of the entire mass, is a rough-and-ready way of attaining much the same result. 



In changing the dressings we make it an invariable rule to co\er the wound 



containing 7 per cent, of the salt instead uf 3 per cent., which is that ordinarily used. Thus the salt 

 required for such a dressing does not really cost iKd. 



B b 2 



