Remarks on the Uses of some of the Bazaar Medicines and Common Medical Plants of India / With a full index of diseases, indicating their treatment by these and other agents procurable throughout India; to which are added directions for treatment in cases of drowning, snake-bites &c.

by Edward John Waring

5. If the liniment is applied to the eruption at a sufficiently early stage, viz., when the eruption is becoming vesicular, the carbolised oil on the surface of the eruption, and the gaseous carbolic acid, between the skin and the cotton and in the interstices of the cotton, prevent the microbes of the atmosphere from coming into direct contact with the epidermis, and subsequently with the contents of the vesicle, the result of which is the contents of the vesicle do not become pustular and purulent; and the eruption dries up without ulceration.

6. If the liniment is applied late in the vesicular stage, or not until the pustular stage has set in, the carbolised oil penetrates more or less into the epidermis which is being thrown off by the suppuration of the pustule; as the pus is discharged by rupture of the epidermis the oil mixes with the pus, disinfects it, and keeps it sweet, as is to be observed by the entire non-existence of, or extremely modified condition of, the horrid stench that accompanies small-pox, subsequent to the pustular stage of the disease.

7. The exuviæ becoming loaded with the carbolised oil, are (probably) disinfected and are incapable of spreading the disease.

8. If the eruption is prevented from reaching the pustular stage, the complications that would otherwise have resulted from pus absorption are no longer to be dreaded, such as the secondary fever, boils, abscesses, acute cellulitis, erysipelas, pyæmia, &c. &c.

No eroding ulcers with deep cavities, leaving the well-known cicatrices of small-pox, are produced.

9. The pustular stage having occurred before the carbolised oil treatment was applied, it still proves of immense value, as it prevents the pus becoming impure and poisonous, and this greatly ameliorates the results of the disease even at this stage.

So long as the disease lasts is this application to be applied, limited certainly to the extent of the eruption; as long as this treatment is being adopted, not a drop of water should be allowed to touch any part of the skin surface (no washing of any sort) until healthy action of the skin has set in, recognised by the falling off of the crops of scabs, without any raw, ulcerated surfaces.

Is there any danger to the patient from the absorption of the carbolic acid into the system? So long as the oily solution is used, and no water allowed to come into contact with the skin, I consider there is little or no danger, but it is necessary always to be careful. Should the patient be suffering from the absorption of the carbolic acid, you will find a cold, clammy skin, rapid fall of both temperature and pulse, and the urine of a smoky greenish-brown colour, and having the odour of carbolic acid. In many cases of small-pox, but where no carbolic acid has been employed, the urine becomes smoky-brown, but it has not the peculiar greenish tinge of where carbolic acid is present. To judge the odour correctly, the urine should be put into a fresh dish and examined in some other room, or, what is better, the open air, so that there can be no mistake, as the air of any house gets so saturated with the odour of carbolic acid that it is not easy to judge whether the odour is that of the air or of the urine. If danger from excess of absorption of carbolic acid is feared, do not give up the treatment, but lower the strength of the carbolic acid in the oil to 1 in 20, and more or less limit the number of the applications. But what is far more important, see that there is abundance of ventilation in the room. I would fear more from a close chamber and excess of carbolic acid vapour in the air than the possibility of the excess of acid having been absorbed from the oil. Remember you are not dealing with a watery solution where there, I believe, is danger, as water, besides quickly evaporating, rapidly yields up its carbolic acid to the tissues, which too readily absorb it. Oil but slowly evaporates, and with difficulty parts with the carbolic acid it holds in solution to the tissues.

All the swabs, mops, &c., of cotton-wool, and the wool itself that may have been employed in treating a case, should be burnt at once when they are no longer required.

The blankets and bedding, after a good washing and exposure to sun, will be found to be free of infection, and may be again with safety employed.