Cotton wool consists of silky fibers taken from cotton plants in their raw state. Impurities, such as seeds, are removed and the cotton is then bleached and sterilized. It is also a refined product (absorbent cotton in U.S. usage) which has medical, cosmetic and many other practical uses. The first medical use of cotton wool was by Dr Joseph Sampson Gamgee at the Queen's Hospital (later the General Hospital) in Birmingham, England.