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James Greenlees

On 12 August 1865, Lister achieved success for the first time when he used the crude oily full-strength carbolic acid to disinfect a compound fracture. He applied a piece of lint dipped in carbolic acid solution onto the wound of an 11-year-old boy, James Greenlees, who had sustained a compound fracture after a cartwheel had passed over his left leg. After washing the wound with carbolic acid in linseed oil, a dressing of putty mixed with the acid was applied widely over the wound and a sheet of tin was then placed to cover the wound to protect it. The putty was used to ensure the acid wasn't washed out of the wound by blood or lymph fluid. The leg was then put in a splint and bandaged to hold the lot in place. After four days, he renewed the pad and discovered that no infection had developed. It was again dressed and left for 5 days. When the second dressing was removed, he found the skin around the wound was burnt. A dressing consisting of gauze soaked in a combination of 5% to 10% acid and olive oil was applied for a further four days. He then applied a water dressing to the wound until healing was complete. After slightly over six weeks, Lister was amazed to discover that the boy's bones had fused back together, without suppuration. Confident that carbolic acid was the antiseptic that he had been looking for, Lister began treating patient after patient at the Royal Infimary in the following months, improving both the wound dressing design and the operating treatment.

During the summer, the Listers never strayed far from Glasgow as he was still monitoring Greenlees. In the same month, he treated two ulcers. Both sores were washed with an acid in oil solution and one was covered with an oiled paper coated with spirit varnish and the second with gutta-percha covered with a water dressing. In both casing the dressing failed and they were swapped for a water dressing that was covered with cotton. On 11 September 1865, the second patient that Lister treated with the acid was Patrick F., a labourer with a compound fracture of the thigh. After the thigh was splinted, the small wound was dressed using lint dipped in carbolic acid and covered in oil paper. After 16 days, the patient had an excellent prognosis. On the 22 September, the Listers decided to take short holiday to Upton and the patient was left with his house surgeon, John Macfee. However, the treatment failed and the limb was amputated after gangrene developed in the wound. When he wrote up his seminal paper, Lister considered the wound sizes to be too small to effectively test the efficacy of the acid, but he was happy with the outcome. In Christmas 1865, the Lister joined the Symes in Edinburgh. It was eight months before Lister treated another compound fracture. In 22 January 1866 he treated John Austin, a shipwreck survivor with a wound in the leg that had developed into a ulcer. The wound was washed in 20:1 oil-to-acid solution and dressed with a lint bandage dipped in the solution and covered with plaster of paris.