SURGICAL DISORDERS.— Carbolic-acid solution (1 to 20) has been used in sur gery as an antiseptic lotion and also to keep instruments in while operating (corrosive sublimate and other antisep tics have almost entirely replaced it for the latter purpose).
For the dressing of wounds, carbolic acid has been used in the form of lotion, carbolized oil, gauze, and spray. As a local anaesthetic for minor operations (removing toe-nail, opening felon, incis ing carbuncle, etc.), it may be used by soaking the part for ten minutes in a strong solution, and afterward applying the pure acid on a brush to the line of incision.
Pure carbolic acid is an excellent ap plication to carbuncles or malignant pustule after incision and curetting; it acts as an antiseptic and anaesthetic as well.
Four injections of a 2- to 3-per-cent. solution into the centre of a boil will usually bring about resolution. Leux (Australian Med. Jour,, Sept. 15, 'SO).
For urethral caruncle, injections of 20 drops of a mixture of equal parts of phenol and glycerol combined with SO drops of water successfully employed. Webster (Mass. Med. Jour.. Mar., '94).
Camphorated phenol diluted with 50 - per cent. of cotton-seed oil used with ex cellent results as a dressing for a severe case of ulcerating epithelioma of the leg. Toms (Internat. Med. Annual, '95).
Case of lupus erythematosus cured by continued use of undiluted carbolic acid, which was painted over the edges of the patches once or twice a week, and boric acid ointment (20 grains to the ounce) applied daily, and especially after apply ing the acid. Minim doses of Pearson's solution of arsenic were also given with mix vomica and tincture of orange-peel.
Carbolic acid is the safest and most effectual form of caustic to use for pa tients with forms of lupus, etc., who are not under close observation. J. Hutchinson (Arch. of Surg., Jan., '98).
S. Sherwell, of Brooklyn, treats nwvi by tattooing them with needles dipped into a 50-per-cent. solution of the acid, afterward cleansing the surface with alcohol, and finally applying a layer of collodion. The results are said to be excellent, little or no scarring being left. Non-suppurating enlarged glands may be treated by parenchymatous injections of 5 to 10 minims of a 2-per-cent. solu tion of carbolic acid. Buboes may be similarly injected with 10 minims of so lution (8 grains to 1 ounce), first be numbing the skin by an ether-spray. This treatment is also good in chronic synovitis (repeated every three days), and for boils and carbuncles if used early enough to abort the trouble.
For the cure of hydrocele, R. J. Levis advised injecting into the tunica nalis 15 to 20 minims of pure acid, after withdrawing the fluid.
Tetanus has been successfully treated by hypodermic injections of a 1-per cent. solution of the acid, conjoined with warm baths and enemata contain ing chloral and potassium bromide.
By means of a series of subcutaneous injections of carbolic acid, hopeless case of tetanus was successfully treated. Patient was a man who had gunshot wound in his left leg, which was fol lowed ten days later by tetanus, com mencing in the muscles of the lower jaw and going on to general spasmodic con tractions. After the tetanus had lasted for ten days subcutaneous injections of carbolic acid of the strength of 2 per cent. were tried, 12 drops being injected every three hours. After two days of this treatment a marked improvement mani fested itself. Injections were continued until twenty-eight had been given, and a few days later the patient was dis charged completely recovered. Osherov ski (Lancet; Indisn Lancet, Nov. 16, '97).
–As a disinfectant carbolic acid is only of moderate effect iveness; although a 2-per-cent. solution will kill most spores and germs, many resist, and even a 5-per-cent. solution requires more than twenty-four hours to kill the spores of anthrax. In all cases of disinfection by carbolic acid an ex posure by contact of some duration is necessary. As an adjunct to other dis infection, the walls and floors of infected rooms may be scrubbed with a solution of carbolic acid, not weaker than 2 per cent. For the disinfection of wounds carbolic acid has been replaced by other remedies, which are as efficient and less harmful, as a deodorized carbolic acid is practically inert.
Study of relative value of disinfectants gives following results: I. Alcohol in the absence of water neutralizes all bac tericidal power on the part of mercuric chloride or phenol with regard to anthrax spores. ores The bactericidal action is not exercised until the dilution of the alco hol with water is greater than 2 per cent. in the case of 1 to 1000 sublimate solution, or than 70 per cent. in the case of phenol. 2. Glycerol interferes with the action of a 2 to 1000 solution of mer curic chloride if the proportion of water be less than 40 per cent. In the case of phenol it is still more manifest. 3. Phe nol and lysol dissolved in olive-oil has no disinfecting action. Lenti (Ann. dell' Inst. d'Igiene sperm. della R. Univ. di Roma, vol. fasc. 4).
Derivatives and Allied Compounds.—