Modern surgery : General and operative / by John Chalmers Da Costa.
- John Chalmers DaCosta
- Date:
- 1900
Licence: Public Domain Mark
Credit: Modern surgery : General and operative / by John Chalmers Da Costa. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![as to have it fresh, for in old solutions much of the soluble corrosive sublimate has been converted into insoluble oxy- chlorid, and the fluid has ceased to be germicidal. In order to make up fresh solutions use tablets, each of which con- tains about ']\ grains of the drug—one of these tablets added to a pint of water makes a solution of a strength of i to looo. Tablets which also contain ammonium chlorid are more soluble than those which contain corrosive sublimate only. Hot solutions of the drug are more powerfully germi- cidal than cold solutions. As corrosive sublimate is irritant, leads to profuse exudation, and may produce tissue-necrosis, it should never be introduced into an aseptic wound. In such a wound it can do no good and may do much harm. Griffin, in Foster's Practical Therapeutics, sets forth the strengths of solutions applicable to different regions : For disinfection of the surgeon's hands and the patient's skin, I : lOOO; forirrigating trivial wounds, i : 2000 ; for irri- gating larger wounds and cavities, i : 10,000 to i : 5000 ; for irrigating vagina, i : 10,000 to i : 5000; for irrigating urethra, I : 40,000 to I : 20,000; forirrigating conjunctiva, i : 5000; for gargling, i : 10,000 to i : 5000. Instruments cannot be placed in corrosive sublimate with- out being dulled, stained, and corroded. Corrosive sublimate may be absorbed from a wound, a serous surface, or a mucous membrane, ptyalism and diar- rhea resulting. The absorption of bichlorid of mercury may be followed by cramp in the limbs and belly, feeble pulse, cold skin, extreme restlessness, and even collapse and death. At the first sign of trouble withdraw the drug and treat the ptyalism (page 257). Carbolic acid is a valuable germicide in the strength of from I : 40 to I : 20. It is certainly fatal to pus-organisms, but weak solutions do not destroy spores. Unfortunately, this acid attacks the hands of the surgeon ; consequently in the United States it is chiefly employed as an antiseptic me- dium in which to place the sterilized operating-instruments, or as a germicide to prepare the skin of the patient before the operation is performed. Carbolic acid is very irritant to tissues, and carbolized dressings may be responsible for sloughing of the wound or dry gangrene. Because of its irritant properties wounds which have been irrigated with it should be well drained. CarboHc acid, like corrosive subhmate, is inert in fatty ti.s- sues. Carbolic acid is readily absorbed, and may thus pro- duce toxic symptoms. Absorption is not uncommon when](https://iiif.wellcomecollection.org/image/b21224870_0030.jp2/full/800%2C/0/default.jpg)
