Lord Lister. 



Vll 



the clot daily with fresh carbolic acid, and later on he covered the crust 

 with a tin cap so as to retain the carbolic acid. The character and progress 

 of these wounds was something quite new to him and to everyone else, and 

 it is not surprising that as case after case followed the same course he and 

 his staff became most enthusiastic over this revolution in surgery. After 

 a time he proceeded to apply the same principle to operation wounds, and 

 the first case in which he used it was a patient with a large spinal abscess. 

 This was opened, and the pus caught and mixed with carbolic acid to form a 

 paste, which was applied over the wound with a tin cap outside in the 

 manner just described. AVhen he came to dress the wound next day he 

 found to his surprise that no pus was coming from the wound, but only a 

 little clear serum. This was a new experience, and a thing which had not 

 occurred to him before, and he was in a difficulty, because he wished to 

 apply a fresh mass of the carbolic acid paste outside, and he had no pus or 

 blood to make it with. By this time he had found that carbolic acid was 

 soluble in oil, and he therefore sent to the dispensary for a solution of 

 carbolic acid in 20 parts of linseed oil and some whiting, and proceeded to 

 make a paste or putty with which he covered up the wound, covering the 

 putty with a piece of tin. This acted admirably and the abscess healed up 

 without any fever or general disturbance — a result of which he had had no 

 previous experience. 



He was now able to get rid of the undiluted acid with its caustic effects, 

 and had at his disposal oily solutions of carbolic acid and the carbolic putty, 

 and with these he proceeded to extend his system, not merely to accidental 

 wounds but to all sorts of operation wounds, and with the most remarkable 

 success. His plan at that time was to cover the skin with carbolic oil 

 before the operation, to soak his instruments in carbolic oil, and to fill up 

 the wound from time to time during the operation with the same oily 

 solution. It is doubtful if any better results can be found even at the present 

 day than those which were obtained at that time by the use of carbolic oil 

 and putty. At the same time the method had great inconveniences ; the 

 putty, for example was very apt to crack and crumble, and the carbolic oil 

 obscured the view. 



After many experiments, Lister introduced a specially prepared lac plaster 

 as a substitute for the putty. This lac plaster was made of shell-lac and 

 carbolic acid covered with a very thin layer of caoutchouc. This mixture 

 was spread on suitable material and wrapped round the wound; outside 

 this cloths were applied to soak up any serum which might exude. 

 About this time also he obtained purer carbolic acid and was able to make 

 watery solutions, and these were substituted for the oily ones. He was now 

 able to carry out a more thorough disinfection of the skin than had been 

 possible previously, for he fully realised that, apart from the dust in the air, 

 bacteria might grow on the skin and so spread into the wound. From the 

 first the necessity of disinfecting instruments and everything which came in 

 contact with the wound had been fully realised by him, and at this time 



