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“From Dilettante to Diligent Experimenter: a Reappraisal of Leeuwenhoek as microscopist and investigator”

The first class of cases to which I applied it was that of compound fractures, in which the effects of decomposition in the injured part were especially striking and pernicious. The results have been such as to establish conclusively the great principle, that all the local inflammatory mischief and general febrile disturbance which follow severe injuries are due to the irritating and poisoning influence of decomposing blood or sloughs. For these evils are entirely avoided by the antiseptic treatment, so that limbs which otherwise would be unhesitatingly condemned to amputation may be retained with confidence of the best results.

In conducting the treatment, the first object must be the destruction of any septic germs which may have been introduced into the wound, either at the moment of the accident or during the time which has since elapsed. This is done by introducing the acid of full strength into all accessible recesses of the wound by means of a piece of rag held in dressing-forceps and dipped in the liquid.1 This I did not venture to do in the earlier cases; but experience has shown that the compound which carbolic acid forms with the blood, and also any portions of tissue killed by its caustic action, including even parts of the bone, are disposed of by absorption and organization, provided they are afterwards kept from decomposing. We are thus enabled to employ the antiseptic treatment efficiently at a period after the occurrence of the injury at which it would otherwise probably fail. Thus I have now under my care in the Glasgow Infirmary a boy who was admitted with compound fracture of the leg as late as eight and a half hours after the accident, in whom nevertheless all local and constitutional disturbance was avoided by means of carbolic acid, and the bones were firmly united five weeks after his admission.