Lord Lister. 



xni 



and there could be no doubt that with further experience the exclusion 

 of infective bacteria could be relied upon. But as regards the second point, 

 the means employed to secure asepsis of the wound did irritate the tissues 

 sufficiently to prevent the realisation of the ideal and led to the exudation of 

 serum to such an extent that drainage was as a rule necessary for two or 

 three days, and so the wound could not be closed and left alone under one 

 dressing. Further, carbolic acid is a poison, and if absorbed into the system 

 in large quantity might give rise to disagreeable results. As a matter 

 of fact symptoms of serious poisoning from absorption of carbolic acid were 

 very rare, but a good many patients had carboluria, which showed that 

 a certain amount of absorption did take place. Further, the method was 

 complicated, and many men would not give the time and care which was 

 required in order to ensure success. The disadvantages of the treatment 

 were, however, not of very much importance in contrast to the fact that 

 septic diseases could be completely avoided by its use, but nevertheless 

 Lister was not the man to rest content with anything short of his ideal, 

 and consequently his further work was in the direction of simplifying the 

 methods and of reducing the irritation of the wounds as far as possible. 



With this object Lister examined every fresh substance which was 

 suggested as an antiseptic, testing them bacteriologically and observing 

 their effects on wounds. He was constantly coming to the hospital with 

 mysterious packets containing all sorts of gauzes or ointments, with which 

 suitable wounds {i.e. those in which there would not be any serious danger 

 if the asepsis were not quite perfect) were dressed, and the results as regards 

 asepsis and irritation were carefully observed. He generally tested them as 

 regards irritation on his own skin in the first instance, and he was frequently 

 seen wearing patches of dressings on his arms in order to test if they 

 irritated the skin. A great variety of substances were tried in this way, 

 such as boracic acid, salicylic acid, picric acid, eucalyptus oil, thymol, 

 various mercurial preparations (bichloride of mercury, biniodide of mercury, 

 albuminates of mercury), iodine, iodoform, chinosol, and so on ; in fact, 

 whenever a new antiseptic substance was suggested it was carefully tested 

 bacteriologically, its effect in preventing putrefaction of blood was examined, 

 its irritating properties and its utility as an application to wounds were 

 tried. The great majority of those substances were rejected for one reason 

 or other, but a certain number were retained and are still employed 

 in surgical practice ; such as boric lotion, boric ointment, and boric lint, 

 eucalyptus ointment, lotions of bichloride of mercury, double cyanide of 

 mercury and zinc gauze, salicylic wool, etc. 



When the mercurial preparations were introduced the use of carbolic acid 

 was very much restricted, and ultimately it was only employed for the 

 disinfection of the skin, and for keeping the instruments sterile during an 

 operation. Sublimate lotions were substituted for carbolic acid, for the 

 cleansing of the hands and sponges during the progress of an operation, and 

 carbolic dressings were replaced by gauze impregnated with mercurial salts. 



