Volume 1

The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.

  • Erichsen, John
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.

    350/1244 (page 322)
    poisoning. It cannot be prepared by the .Surgeon himself under ordinary circumstances, it gradually loses its virtues by keeping, and it is somewhat ex})ensive. For these reasons it is less frequently used now than it was a few- years ago, its place being taken to a very great extent by the mercurial dress- ings, or by some form of absorbent wool. Eucalyptus Gauze (p. .-^Ol) and Thymol Gauze have been substituted for the carbohc in cases in which the latter caused iri'itation or symptoms of poisoning. They are applied in the same way as the carbolic gauze, and when quite freshly prepared, may be relied upon to prevent putrefaction ; but they quickly lose their virtue, owing to the gi'cat ^olatihty of the antiseptic. The application of various antiseptic lotions on lint is a common mode of treatment, and is often attended by very good results, but if the discharge be abundant, decomposition is very apt to occur. Carbolic acid lotion (1 in 40) may be used in this way, but it requires very fi-equent changing, as the acid rapidly volatilizes. It is, moreover, apt to irritate the wound, and to interfere with union. Boracic acid lint soaked in a concentrated solution of boracic acid is less irritating, but it is not a very powerful antiseptic. The addition of one-fourth part of glycerine to the lotion prevents the hnt from drying, but it is rather a painful application to a raw surface. Jonathan Hutchinson recommends the application of a piece of lint constantly moistened in the following solution : Liquor plumbi ^ss., Sp. Rect. 3], Aq. Oj. This treatment was ranch employed in former times, and is attended by excellent results. The solution is powerfully antiseptic, and it is cooUng and gi-ateful to the patient. It requires, however, constant attention to prevent the lint from drying, and in this respect is somewhat troublesome, especially in private practice. Oil containing some antiseptic in solution is one of the most ancient forms of dressing. Lint soaked m carholic oil (1 in 10), applied so as to extend for some inches round the wound, may occasionally be useful in the absence of more convenient means, but it is not a very satisfactory dressing. It is a feeble antiseptic, and is apt to stick to the wound and become dry. It should be changed at least twice a day. Bryant, at Guy's Hospital, after washing the wound with a weak solution of tincture of iodine and water (5ij. to Oj.), applies lint soaked in a mixture of one part of terebene to five parts of olive oil, and with this dressing he has obtained most satisfactory results. All these modes of treatment involve somewhat fi'cquent dressing, and conse- quently some degree of disturbance of the wound. II. The antiseptic dressings belonging to the second group are very numerous. They have the following points in common. First, the material used is more or less elastic, and is applied in large quantity, and secured by a bandage with some •firmness, so as to exert a uniform pressure on the wound. This is the principle of (xuerin's cotton-wool dressing already described (p. 315). Secondly, it is absorbent—the more so the better—so that the discharges shall diffuse them- selves widely through it. Thirdly, it is impregnated with some efficient chemical antiseptic, which, becoming dissolved in the discharges, prevents their putrefaction. Fourthly, the dressing is not covered by any waterproof materia], free evaporation being encouraged, so that the discharges, becoming <lry, may be thus certainly prevented from decomposing, and the wound may Ileal as under a scab. FiftUy, if the object of the dressing is attained, and