A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

    44/554 (page 32)
    tion. It is objectionable, as it in time discolors bright instruments and soon destroys their cutting surfaces. For this purpose we have abandoned Its use durmg the last year at the Episcopal Hospital in Philadelphia, and substituted the boiling of instruments in distilled water (made slightly alkahne with soda or ammonia, which prevents in a measure the discolor- ation brought about by boiling), trusting to the purifying effect of moist heat. In using the stronger carbolic acid solution, surgeons find great inconvenience from the unpleasant benumbing effect produced by having the fingers moistened by it even for a short period of time, in cold weather causing the hands to chap greatly. The more recent practice of Listerism is to use carbolic acid spray so as to keep the wounded surfaces under a fine mist of carbolic acid (i to 20) diluted with steam to i to 40, while carbolized oil cat-gut (by preference that prepared in chromic acid) is used for the ligation of arteries. The dressing in vogue is (i) specially prepared oiled silk on which a number of coats of dextrin have been painted, as a protection from the irritating effects of the acid ; (2) a coarse gauze made of cheese-cloth, impregnated with a mixture of car- bolic acid, paraffin, castor oil, resin and alcohol. About eight layers of the gauze are laid over the wound, which has previously been thoroughly cleansed with the i to 20 solution. Over this is laid a piece of mackintosh, wrung out of a solution of the same strength, and the entire dressing is retained by means of a bandage made from the gauze. For a number of years a solution of carbolic acid in olive oil (i to 10) has been used in the Pennsylvania Hospital. Lint saturated with this mixture is laid over the wound. Although worthless compared to the more modern antiseptic dressings, it is an exceedingly bland, clean, and pleasant application, especially to some varieties of Burns and for the packing of sinuses about the rectum after operations for the cure of Fis- tula. A similar preparation of carbolic acid and oil, though weaker (i to 20) is largely used to anoint instruments in urethral surgery, being much more convenient than cosmoline, the slight amount of carbolic acid having a sedative effect on the urethral mucous membrane. Lund^s Oir^ is a favorite preparation in England for Anointing Catheters. It consists of olive oil and castor oil, each one ounce ; carbolic acid, one drachm. It will be found usually more convenient in making solutions of carbolic acid to first dissolve it in glycerin, as then the globules of the acid are more readily broken up when they come in contact with water. In making solutions for baths for instruments, etc., (i to 40 and I to 20) the strength can readily be judged very accurately by the taste, by applying a little of the solution on the end of the finger to the tongue; by this means much time and trouble are saved. Carbolic acid locally applied is an anjesthetic. A. H. Smith painted on his forearm a spot an inch in diameter, with an 85 per cent, solution