Since the time that I first gave my opinion to Dr. Waring (in 1872) upon the treatment of small-pox with carbolised oil, I have seen a good deal more of the disease, and I still, with slight modifications, maintain my preference for this form of treatment. When I first used the application I employed a mixture of one part of Carbolic Acid and ten parts of Sweet Oil, applied twice daily over the whole body. I now advocate the employment of one part of Carbolic Acid to fifteen parts of any bland or Sweet Oil, moistening the body on such parts as may require it, frequently during the day and night.
Sesamum or Til Oil is ordinarily the most easily procurable throughout India, but any of the following will do: Poppy, Ground-nut, Apricot, Walnut, Cocoa-nut, Linseed, Almond, or Olive Oil, the two last being rather expensive. On no account be led into using any of the Mustard oils, which, owing to the natives using some of them in their diet, are occasionally spoken of as "sweet oils."
At whatever stage of the disease the patient comes under treatment, at once apply this liniment over all the parts being affected, or are affected by the eruption, by means of a mop of soft cotton-wool (never on any account employ a sponge); apply the liniment freely as if you were treating a severe burn, and then carefully cover the oiled surface with cotton-wool, so as to exclude all air, and keep the cotton-wool dressing in position. The carbolised oil to be freshly reapplied every four or six hours, so as to keep the parts moist, and the cotton-wool to be renewed every forty-eight hours. If flakes of wool stick into the broken skin, moisten these freely with oil, but do not tear them away. Any amount of cotton-wool can be obtained throughout India at the smallest hamlet, on a few hours' notice; and at all hours in any bazaar.
Let the patient lie between blankets, not cotton sheets; in commencing to dress the patient on the first occasion have a layer of cotton-wool placed upon the lower blanket, then place the patient on this cotton-wool naked, cover with a similar sheet of cotton-wool and over this again a blanket; having done this, set to and piecemeal dress the whole body, where the presence of the coming eruption requires it, with the carbolised oil, and cotton-wool, supporting the position of the cotton by means of very light bandages, or by a few stitches with a needle and thread, so as to keep the wool carefully together as well as firmly against the body. If suitable under the circumstances, a thin elastic gauze jersey and drawers keep the cotton protected from being rubbed off by restless patients.
So soothing and comforting is the application of the oil, that almost the youngest patients look forward to its re-application, will at once tell you when the body is getting hot and dry, and will in all probability ask to be allowed to apply the liniment themselves when they begin to feel uncomfortable, especially at the inflammatory stage of the vesicles when they are just changing to their pustular condition.
What is gained by the above treatment?
1. The carbolised oil soothes and cools down the inflamed surface of the skin, exactly as is done when oil is applied to a burn.
2. The cotton keeps all air from the skin, and aids in keeping the skin moist with the oil.
3. The oil saturates the surface of the eruption, penetrates into the skin desiccation, and as the oil becomes heated by the temperature of the body it gives off some of its carbolic acid in the form of gas.
4. The carbolic acid keeps the oil from becoming rancid.