Replete of vermin

carbolic acid in ColombiaIn 1869 Dr Felix Rubio, a physician in Colombia, wrote to the Medical Times and Gazette on the subject of carbolic acid. This substance, known today as phenol, was one of the first antiseptic compounds to be used in medicine – Sir Joseph Lister was an enthusiastic proponent. Since adopting its use, Dr Rubio had found it invaluable in Colombia, a country he described as

warm, damp…[with] all the propensities peculiar to evolve suppuration and gangrene, and to engender vermin of every description.

Really makes it sound like a dream holiday destination, doesn’t he? To illustrate his satisfaction with the disinfectant properties of carbolic acid, Dr Rubio narrates a recent case:

Dionisia, a poor, miserable, wretched black woman, 35 or 36 years of age, with filthy and scandalous habits, had suffered for many years from syphilitic ulcers, which had destroyed the palate, part of the upper lip, and the cartilage and septum nasi of the nose. She was shot lately in her right leg. An ounce lead ball entered clean through the upper and external third of the leg, some five or six inches below the knee-joint, passing between the lower part of the head of the tibia and the internal side of the superior extremity of the fibula, without lacerating either of the two bones.

From which we gather that she really wasn’t enjoying much luck. Dr Rubio examined her shortly after this incident and found that the bleeding was slight, so simply bandaged the wound. He next saw her two months later:

I was called to her, and found the leg completely gangrenous. I was told that this woman had been in a fair way for the first six or eight days after the accident; that one day a venomous fly—there are many of these in this country—sat on the wound, and discharged there a great number of maggots, which in due time all changed into as many vermin, which soon invaded all the soft parts of the leg, and caused a complete sphacelus of the whole limb.

A ‘sphacelus’ is a gangrenous or necrosed part of the body. Essentially, the tissue of the limb was dead. In this condition there is nothing to be done except amputate.

The foot and the leg up to the knee were now black, soft, and completely replete of vermin, which formed wavelike movements under the putrid skin, and made the most disgusting sight to look at. The smell was horrible.

It sounds absolutely ghastly. There’s really no need for Dr Rubio to tell his readers any more, but he insists on doing so:

There cannot be anything more repugnant and horrible than the sight of this woman’s leg; and, notwithstanding the putrefactive and loathsome state of her limb, the nastiness in which she was inundated, both as to her body and clothing, and the great misery in which she was involved, she was fat, stout, and fleshy, as if she had been fed on her own filth.

Oh come on, doc, she’s having a bad time of it already. Do you have to insult her too?

She was very hungry. I immediately ordered her to wrap up her knee with cloths dipped in a solution of carbolic acid (1 part) and cold water (30 parts), which in a very few hours disinfected the noxious knee, and three days after I separated the putrid limb. I washed well the raw surface with the same carbolic acid solution, and placed the lower flap in apposition with the upper one, and kept them in situ by wire stitches. I ordered the carbolic acid solution to be applied constantly to the ulcer, and two weeks afterwards the stump was well.

Still – small mercies, eh?

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