Value Of Antisepsis

These last 20 years surgery has beon advancing at an almost vertiginous pace and its progress and improvement are due to the universal practico of antisepsif and to the adoption of proper dressings. The most daring operations are now crowned with success, and different viscera which had previously been carefully avoided by surgeons are treated safely and to the welfare of the patients. It is an every day occurrence to eee the abdominal cavity opened either to remove a tumor or tomakesome operationon the intestines. The brain islaid bare to f ree it from some compression from which it is suffering or to open an abscess and give a free exit to the pus. Under all these circumstances the surgeon intervenes with perfect security when he has ininutely taken the necessary precautions to protect the wound he creates from infection by gernis. These dangerous geruis are both within the patients and about them, and for this reaeon it is absolutely indispensable to disinfect the spot that the operation is to affect and also everything connected with the operator, his instruments or assistants. As for the germs floating in the atmosphere, some surgeons endeavor to counteract their effect by spraying antiseptic liquids about the room during the operation. The point to be guarded against above all others is infection of the seat of intervention, and this can be accomplished by destroying the germs that may have already invaded it or by closing up all access to it on the part of those that may be about it. The former can "be effected by the use of antisepsis and the latter by asepsis. Complications arising from firearm wounds seem to result from the action of germs which are not carried by the projectiles, as might be supposed at first thought, but by the patients' olothing. In one of the late meetings of the Societe Imperio-Royale des Medecins de Vienne, M. Habart reported the experiments he had undertaken in this connection with M. Faulhaber concerning the infection of firearm wounds. These twu investigators, using regulation rifles, fired at boxes of gelatin, of whú-u some were sterilized or covered with sterilized blottinec üaner. others surrounded with nieces of old uniforms and others with pieces of uniforms dipped in pure cultures of staphylooocci. In the first case the track of the bullet reinained asceptic; in the second were found, in addition to pieces of cloth, a variety of microbes, while in the third the boxes contained nothing but staphylococci. In short, a bullet striking the body of a soldier or a piece of shell entering his flesh stands every chance of creating an infected wound. It is therefore iruperative to treat all wounds in wartirue antiseptically, and we owe a great debt to the different authorities who in time of peace are preparing a sufficieut stock of packages of dressing to supply each soldier or officer on the day war may break out. This small package of dressing with whlch each soldier is to be furnished is to be placed, in the French army, in a pocket specially preparedfor it and is certain to render great services, whether used by the wounded man himself or by the ambulance corps. However temporary this remedy may be, it will still have the advantage of supplying the regimental surgeon with almost enough dressings for the ñrst mands on the battlefields without his having to make use of his stores, and it will rapidly place the wounds out of reach of the danger of infection arising from contact with clothing, hands or the ground. A Germán army surgeon, M. Koerfer, has been testing the value of inhalations of chloroform in the cerebro-spinal form of sunstroke, and in the case of two soldiers very seriously affected with unconsciousness, convulsions, hypersesthesia of the skin, livid skin and weakened pulse, the prolonged adininistration of chloroform succeeded in putting an end to all the symptoms. The favorable effect of the chloroform showed itself as soon as its use was commenced by marked improvement in the pulse, but the convulsions did not cease altogether until the narcosis had been kept up for an hour and a qnarter in one case and for a quarter of an hour in the other. The use of cold water and hypodermic injections of ether, Ê which recourse was had in the first case, where the iymptoms were particularly serious and jefore the chloroform was tried, were found to be powerless and to have no other effect than to bring on or increase the convulsive attacks each time they were tried. With this patiënt M. Koerfer also made an injection of two centijrams of morphine toward the end of ;he chloroform seance, and when the man began to come out from the effect of the chloroform he feil asleep again under the influence of the morphine, and on awakening finally the cotivulsive atacks had entirely disappeared. Chloroform acts in these cases by stop)ing the convulsions which help to raise he temperatura of the bodv bv he production of heat and also by faciltating the radiation of the heat of the body. Hypodermic injections of ether are given to prevent asphyxia, and cafeine administered in the same way bas a twofold purpose, to increase or re-esablish the urinary secretion and to tonfy the system in general. In the fu;nre it will be well to bear in mind the usefulness of chloroform in these very evere cases oí