174 
THE USE OF CARBOLIC ACID. 
treatment on the constitutional condition of the patient, and 
on his chances of ultimate recovery; Mr. Lister^s views on 
this point are well known ; and the experience of this hospital 
goes to confirm them in every essential particular. Mr. 
Lister teaches that with carbolic acid dressings the febrile 
disturbance which follows operations is notably lessened ; 
that suppuration is enormously diminished, and that the 
really perilous form of suppuration—that, namely, which he 
has designated septic,and which depends on the irrita¬ 
tion produced by the decomposition of the discharges,—is 
altogether abolished; that, as a consequence of this, the 
perils of hectic and pyaemia are reduced to a minimum; 
and that, as the result of the whole, cicatrisation and recovery 
are accelerated. We shall glance at these points seriatim. 
First, as to the pyrexia immediately following the opera¬ 
tion. A number of careful observations have been made on 
this point by the house-surgeons in the course of last summer, 
with this general result,—that after all capital operations a 
decided elevation of temperature is found, ranging commonly 
from lOO'^ to 102° Fahr., whether the wound be dressed with 
carbolic acid or otherwise; but that with carbolic-acid dress¬ 
ings the fever is less severe, and is of notably shorter dura¬ 
tion. Individual cases differ much in this respect; in some 
cases dressed by the old method the febrile disturbance may 
be insignificant, while in some dressed antiseptically it may 
be severe, and this without any assignable cause. But a 
broad review of a number of cases treated by the two methods 
points to the conclusion stated above. 
Secondly, as to the effect of carbolic-acid dressings on 
suppuration. It is rarely or never found that a wound of 
any considerable size heals under carbolic-acid dressings 
without the formation of some pus. But this pus, in a 
successful case in which the antiseptic effect has been 
thoroughly attained, is always inconsiderable in quantity, 
and altogether free from smell, and is evidently secreted in" 
great part, if not entirely, by the granulating surface at the 
part of the wound left open for the escape of discharges 
under the irritation of the carbolic-acid dressings, with which 
the granulations are necessarily in contact. If the suppura¬ 
tion extends farther, or if the pus secreted gives evidence by 
a fetid smell of having undergone decomposition, the anti¬ 
septic treatment has, pro tanto, failed. 
On the whole, the best general results have been obtained 
in connection with the opening of abscesses. Some of 
these cases have been remarkable successes; and there has 
not been one failure, nor a single case in which a doubt was 
