362 
NOTE  ON  CARBOLIC  ACID,  ETC. 
wonderful,  in  many  respects  ;  and  not  the  least  wonderful  of 
these  results  is  the  apparent  impunity  with  which  so  powerful 
and  so  caustic  a  substance  as  the  crystallized  Phenol  has  been 
introduced  between  the  flaps  in  surgical  operations,  and  within 
the  wounds  and  injuries  in  compound  fractures,  etc.  This  incon- 
siderate and  heroic  practice  cannot,  however,  be  needed  or  justi- 
fied in  order  to  obtain  the  best  results  of  the  agent ;  and  he 
must  be  a  bold  man  who  originated  the  practice,  unless  he  reached 
the  results  by  the  failure  of  more  dilute  applications.*  All  sup- 
purating surfaces,  whether  of  pyogenic  membrane  or  of  altered 
mucous  membrane,  appear  to  be  benefitted  by  the  application  ; 
but  it  is  often  a  very  nice  point  to  determine  the  strength,  or 
rather  the  dilution,  best  adapted  to  the  object  in  view.  For 
gargles,  washes,  injections,  &c.,  used  in  relation  to  inflamma- 
tions, suppurations,  etc.,  the  standard  solution  is,  in  a  large 
majority  of  cases,  much  too  strong,  even  when  the  weaker  crystal- 
lized Phenol  is  used.  Under  this  division  of  its  uses  may  be 
classed  its  applications  in  diptheria,  croup,  aphthous  diseases, 
chronic  cystitis,  leucorrhoea,  ulceration  of  the  rectum,  fistula, 
abcess,  carbuncle,  etc.  From  some  observations  yet  incomplete 
and  unpublished,  it  appears  to  be  very  effective  in  the  treatment 
of  gonorrhoea  and  primary  chancre,  an  efi"ect  well  understood 
if  the  zymotic  character  of  these  diseases  be  proved.  In  all 
herpetic  and  impetigenous  diseases  of  the  skin  it  is  very  effective. 
The  writer  has  seen  half  a  ring-worm,  herpes  circinatus,  cured 
by  it,  whilst  the  other  half,  to  which  it  was  not  applied,  remained. 
Dilute  solutions  used  as  mouth  washes  soon  wear  out  the  at  first 
unpleasant  taste  and  odor,  and  when  habitually  used,  as  in  the 
*  Since  this  paper  was  written  Professor  Lister,  of  the  University  of 
Glasgow,  to  whom  this  criticism  refers,  has  used  a  watery  solution,  which 
he  says  has  in  no  instance  failed,  and  which  being  a  less  powerful  irritant 
does  not  produce  sloughing  from  caustic  action,  nor  produce  obstinate 
vomiting  for  twenty-four  hours  after  its  application,  as  the  crystallized 
acid  sometimes  did.  Professor  Lister's  papers  "  On  the  Antiseptic  Sys- 
tem of  Treatment  in  Surgery  "show  how  easy  it  is  to  overdo  a  good 
work,  and  to  almost  hopelessly  complicate  a  simple  expedient  in  surgery 
by  cumbrous  and  hurtful  directions  and  details.  That  an  earnest,  honest 
worker  may  sometimes  do  this  is  within  the  experience  of  the  writer  of 
this  note. 
