From The Military Surgeon: Journal of the Association of Military Surgeons of the Unites States, Charles Lynch, Ed. Volume 28. Washington, D. C.: 1911, pp. 69-71
THE CONGENERS OF PHAGEDENA AND THEIR TREATMENT WITH TURPENTINE.
BY GEORGE ROSS, M. D., RICHMOND, VA, Consulting Surgeon, Southern Railway; Ex-President, International Association Railway Surgeons; Ex-President, Association Surgeons Southern Railway; District Surgeon, C. & O. Railway; Emeritus Professor Obstetrics, University College of Medicine, etc.
DURING the spring of 1862 I was a medical fledgling, fresh from the halls of the University of Virginia, and proud of the M. D. degree she had so recently conferred on me. I was on duty at the Banner Hospital in Richmond, Va. (so named by the Surgeon General of the Confederate States because of its conspicuous cleanliness). The hospital was filled with sick and wounded soldiers from the battlefields of the memorable seven days’ fight around Richmond. The dreaded hospital gangrene secured a foothold in the hospital, and I found myself face to face with it in the person of a young medical student. He had received an abrasion on the front surface of his thigh inflicted by a spent ball. The wound progressed satisfactorily for a time under the universally employed cold water dressings of those days when, suddenly, granulation ceased and the characteristic slough of gangrene manifested itself; a dirty, greenish, fetid and jelly-shaking mass of dying tissue, creeping saurian-like beneath the contiguous skin. Of course, I was demoralized and sought the counsel of the surgeon in charge, the late Dr. William Alexander Thom, of Northampton county, Va., than whom there were few abler surgeons, and no man worthier to be known as a courtier among gentlemen-physicians. Efforts to expedite the casting off of the decaying mass were advised, and such deodorants as were then available were employed. Alternating charcoal and crushed carrot poultices were locally applied, and dilute solutions of Labarraque’s disinfectant rigorously resorted to. Food and whiskey, such as we could get, with bark and ferruginous tonics were the armamentaria of constitutional upbuilding, while the normal conditions of the bodily functions were carefully guarded. Bad to worse was the record of succeeding days, and the open grave seemed yawning for an occupant. I was in despair and quick to adopt a suggestion. Walking from the ward and bedside of my patient toward the officer’s hospital, nearly a mile away, I chanced to meet Dr. James Read, then surgeon in charge of that hospital, formerly from Savannah, Ga., and for many years after the war a prominent figure in the medical circle of that city. Telling him of my anxiety and its cause, he listened with that courteous and patient attention which should ever mark the elder brother hearing the recital of a disturbing case by a junior seeking help, and sent me away cheered by the assurance that, when his advice had been acted on, the end would be well. His instructions were to mop the sloughing mass to saturation with pure spirits of turpentine, cover with a dressing and give the patient a teaspoonful of the drug every two hours, and, added that by the end of forty-eight hours the slough would have fallen out, leaving a granulating surface red as a beef steak in its stead. I obeyed instructions to the letter and his predictions were fulfilled, my heart made happy, and my patient made to enter on the road to an uneventful recovery.
Six months later I was transferred to Chimborazo Hospital and assigned to the first division, Dr. P. F. Brown, of Accomac county, Senior Surgeon. At the morning assembly of the entire staff surgeons were required to report all cases demanding the attention of the consulting board. One of the assistants, Dr. Minge, asked aid in a case of hospital gangrene, involving almost the whole of the gluteal region of one side. When older heads had expressed their views, I modestly ventured to report the case just read to you. The treatment was new to all my hearers, and he asked me to try my hand on his case. I gladly did so, and had much satisfaction in converting the despair of a sufferer into hope, and hope into assured health.
I have recently had under my care a series of sloughing ulcers on the calf of a man's leg—ulcers that I might have suspected of being the site of suppurating gummata, had there been occasion to justify a suspicion of their existence. But no history, confessed or discovered by critical investigation, warranted the assigning of such a cause.
The man’s health was otherwise perfect and had been so throughout his entire life. He had not been sick in many years, and was still on his feet and daily behind his counter when he came under my care. He first had what his wife thought was a
boil, an ordinary phlegmon, and so she poulticed it, but it did not get well. On the contrary, there came another and a bigger one, and she thought that was due to his falling and scraping his leg against a log of wood. Stinking, black dug-outs they seemed to be when I saw them, with œdematous tissues all around, some of the sloughs communicating by dark subcutaneous, slough-lined passages. Four weeks of persistent effort for their cure found me a failure, bolstered, as I had continuously been, by the full antiseptic paraphernalia of the modern surgeon, from curette to sterile gauze dressing.
My patient grew steadily worse, and then it was that the “steps already trod” were retraced, and I found again the friend that had so satisfactorily served me in the days of my youth. Two days of turpentine treatment did the work as of old, and the hen that laid my golden egg was dead—Othello’s occupation was gone. A single contretemps is worthy of note in this case: Hematuria developed on the second day, but disappeared promptly with the withdrawal of the drug. The question of rationale of treatment naturally suggests itself to your minds, and I answer it: Pure spirits of turpentine, locally applied to a fresh cut or foul sore, is nature’s perfected destroyer of germ-life, the ideal non-corrosive, innocuous disinfectant, and, when administered internally, save and except only adrenalin chloride, the product of the suprarenal capsules, is the most efficient capillary astringent known.