Antisepsis

“ Asepsis aims at thorough sterilization of the parts and of all the objects brought into contact with the wounds, and the exclusion of germs by the use of occlusive bandages and dressings.
Antisepsis is that method of wound treatment which keeps germicidal agents continuously in direct contact with the wound. Its object, therefore, is to produce asepsis. It is the duty of the surgeon to guard against the contact of microorganisms in the wound and to employ whatever means science has evolved for their destruction. ”

“ But now a flareup had occurred. The Lancet brought in supplies of the antibiotic, and Tiger Martin spent two days showing Singallese physicians how to control further outbreaks with modern methods of immunization and antisepsis. ”

“ This was particularly true prior to the [p149] development of antisepsis. Antiseptic techniques, of course, were based on discoveries by Lister, Pasteur, and others first announced in 1867, but were not generally accepted and employed until about the turn of the century. ”

“ OBSTETRIC SEPSIS AND ANTISEPSIS. Auvard, writing to the Annals of Gynec., April, 1888, says, while before the days of antiseptics it was better for a woman to be delivered in the street than in a hospital, the hospital ward is now less dangerous than the isolated lying-in chamber of the out-patient obstetric service. He points out the importance of improving the resisting power by use of tonics before the labor, in debilitated patients. ”

“ Much stress has been laid upon the subject of asepsis and antisepsis. The foot is peculiar in that conditions surrounding it are especially congenial to the development and multiplication of bacteria. Modern surgery has been built upon the recognition of the rôle of bacteria in the behaviour of wounds, and the greatest hazard to successful surgery lies in the ever-present possibility of bacterial invasion. Surgical safety, however, can be secured by the employment of a perfect technic for asepsis. ”

“ In short, the technics of modern surgery is based on Lister's method, and takes for its watchword, 'asepsis without the use of antiseptics.' Antisepsis has given place to asepsis, but the latter is just as surely based on the ground first broken by Lister. ”

“ In considerably less than a hundred years hence such makeshifts as drugging, and the fighting of one disease by the instalment in the organism of another, will certainly have gone by the board. Antisepsis and Asepsis (the latter almost infinitely the greatest invention in the history of therapeutics) will have pushed their way from surgery into medicine. There are numerous diseases which can be not merely cured, but ultimately abolished when we have once discovered how to use oxygen adequately. ”

“ Here we have a disease always exhibiting the same symptoms, more or less peculiar to one class of animal, always with a similar characteristic appearance and smell, always obstinately refractory to treatment, showing always a tendency to spread to the other feet of the same animal, and often to the feet of other animals near enough to become infected, and always cured—when cured it is—by a treatment which may be summed up in two words as 'rigid antisepsis.' Other diseases, with points in common with this, have been directly proved to be due to a specific cause. ”

“ Edgar says that “there is no doubt that the presence of puerperal sepsis in many of the cases is something more than a coincidence.” Alienists assure us that since the introduction of antisepsis into midwifery the frequency of puerperal insanity has been marvelously diminished. Many cases of this type of psychoses are said to exhibit more the nature of delirium—such as is seen, for instance, in typhoid fever—than of actual insanity. Again, the coincidence of severe local infection has often been remarked, and gives color to the toxic theory ”

“ They collect a number of victims, operate on them, and then move on before their sins can find them out. Both kinds of operators seem to be innocent of any attempt at securing asepsis or antisepsis; they use a dirty needle or a sharp wooden skewer ”

“ He utilises every particle of the marvellously minute and intricate technique of asepsis to prevent the entrance through the wounded tissues of any disease elements before, during or after the operation. He fears sepsis equally with death, and yet, under the blighting and blinding influence of an ancient and venerated myth inherited from his ignorant and superstitious forbears of a pre-scientific age, he will deliberately inoculate the virulent infective products of diseased animal tissues into the circulation of a healthy person. ”

“ PREFERRED ANTISEPTICS ANTISEPTIC SOLUTIONS
These are solutions used for the destruction of and to arrest the progress of microörganisms that have found their way into wounds—the cause of sepsis, as exhibited by fever, suppuration, and putrefaction. These preparations are called antiseptics and are used to render parts aseptic. They vary much in their destructive power, effect on tissue, and toxic properties. ”

“ It is probable that these complications are all the result of septic infection and absorption, and since the modern antiseptic treatment of burns they have become much less common. The third period is prolonged until recovery takes place. Death may result from septic absorption, or from the wound becoming infected with some organism, as tetanus, erysipelas, &c. The prognosis depends chiefly on the extent of skin involved, death almost invariably resulting when one-third of the total area of the body is affected, however superficially. ”

“ In some cases the knowledge obtained has led to a control of the attack or of the poisonous action of the parasite. Antiseptic surgery, by defeating the poisonous parasite, has saved not only thousands upon thousands of lives, but has removed an incalculable amount of pain. Control is slowly being obtained in regard to several others among these deadly microbes in various ways, most wonderful of which is the development, under man's control, of serums containing anti-toxins appropriate to each disease, which have to be injected into the blood as the means of either cure or protection. ”

“ Septicemia may be defined as an acute febrile affection, characterized by marked nervous, cutaneous and visceral manifestations, and due to the introduction into the system of bacteria and their toxins from an infected wound. It applies to diseases which present poisons in the blood that are of parasitic origin, the parasite itself being either present or absent in the blood. Septicemia, in strong contrast to the definition of toxemia, would include diseases arising from the invasion of the tissues and fluids of the body by animal or vegetable parasites or their poisonous products. ”

“ The symptoms of sapremia depend upon the amount of intoxication.
In septic infection, or septicemia, only a small number of organisms may get into the blood, but they multiply rapidly. A drop of blood from a man with septic infection will reproduce the disease when injected into the blood of an animal; hence it is a true infective disease. The wound in such a case is often small, and is commonly punctured or lacerated. ”

“ But though the pendulum has swung so far in the direction of aseptic surgery, a very large proportion of operators still adhere to the antiseptic measures which had proved so highly beneficial. The judicious employment of weak solutions of carbolic acid, or of mercuric salts, and the application of unirritating dressings of an antiseptic nature cannot do any harm, and, on the other hand, they may be of great service in the case of there having been some flaw in the carrying out of what should have been an absolutely aseptic operation. ”

“ The micro-organisms are conveyed by the blood-stream to different parts of the body, in which as in the original wound itself they both multiply and set up factories for the production of toxins. The disease commonly follows blows or wounds which have not been treated on surgical lines. Much laceration of the tissues at the time of the injury offers increased liability to infection. Septicaemia is frequent in spreading gangrene, in diseases of the periosteum, and in fevers such as scarlatina, diphtheria or plague, and in the puerperal state. ”

“ For a day or two at the time when the inflammation is at its height it may be well again to guard by a shield against injury from a blow or push, but the shield should always be regarded as itself a danger. If by any accident the vaccine pustule becomes infected, it should be treated like any other infected wound,—the crust removed, the ulcer cleansed with antiseptics and dressed surgically. The immunity given by the pock is not at all lessened by this treatment. ”

“ All cleansing operations and antiseptic processes are instituted with the sole idea of preventing the entrance of germs into the wound, either from the hands of the operator, the dressings, instruments, or the skin of the patient.
Antiseptics are chemical substances which have the power of killing germs outright, or so checking their growth that the cells in the blood can easily cope with them. The antiseptics that are mentioned in these notes are carbolic acid, chinosol, permanganate of potash, and boric acid. ”

“ The usual faults in technique are a lack of cleanliness, resulting in sepsis, the use of too strong an antiseptic when cleaning the skin, over-heating of the lancet, needle or scarifier when purifying it, drawing too much blood, which washes away the lymph, exposure of the recently vaccinated area to the hot sun, and charring of the lymph in the capillary tube when sealing. All that is necessary is to clean the part to be vaccinated with soap and water, using a nail-brush, then rub the skin with alcohol, and when the latter dries proceed with the little operation. ”

“ The term _sepsis_ as now used in clinical surgery no longer retains its original meaning as synonymous with "putrefaction," but is employed to denote all conditions in which bacterial infection has taken place, and more particularly those in which pyogenic bacteria are present. In the same way the term _aseptic_ conveys the idea of freedom from all forms of bacteria, putrefactive or otherwise; and the term _antiseptic_ is used to denote a power of counteracting bacteria and their products. ”

“ The prompt removal of the cause of septic absorption, the flushing out of the wound with weak antiseptic solutions, in order to mechanically remove any decomposing masses, and the establishment of proper drainage in deep wounds, is usually followed by a fall in temperature and an improvement in the general condition. A strong, preferably mercurial, purgative should be given to aid in the elimination of toxic material. For the same purpose the injection into the veins or into the cellular tissue of large quantities of normal saline solution is useful. ”

“ The operation for the removal of a malignant growth causes no real suffering when it is done by the surgeons of to-day, who employ anesthetics for preventing pain during an operation and antiseptics for limiting inflammation afterward. The scientific antiseptic methods of wound treatment deal directly with species of microbes with which naturalists are familiar. According to present beliefs, suppuration and "blood-poisoning"—pyæmia, septicæmia, erysipelas, and lock-jaw—are due to the growth in the wound of microbes which are parasites there ”

“ Bacteria were known to exist but had not yet been accepted as a cause of disease. Antiseptic surgery was still in the future, and asepsis was not yet even an ideal to be sought. The occurrence of pus in wounds or as a result of surgery was looked upon as part of the process of healing, a necessary suppuration. ”

“ Although many colds may be started by a virus, it is these "secondary invaders," say many authorities, that are responsible for much of the misery you know so well. Listerine Antiseptic, if used frequently during the 12 to 36-hour period of "incubation" when a cold may be developing, can often help forestall the mass invasion of these germs and so head off trouble.
Listerine Antiseptic's remarkable germ-killing action has been demonstrated time and again. ”

“ In sapremia the blood contains the toxins and dead saprophytic organisms. In septicemia the blood contains both pyogenic toxins and multiplying pyogenic organisms. In sapremia the causative condition is putrid material lodged like a foreign body in the tissues. In septic infection the tissues themselves are suppurating, and both bacteria [Pg 50] and toxins are absorbed by the lymphatics. Of course, septic infection may be associated with septic intoxication or may follow it. ”

“ WHAT VACCINATION REALLY IS AND HOW PUS INFECTION, LOCKJAW, AND OTHER DISEASES WORK TOGETHER IN VACCINATION WITH FATAL EFFECTS Every act of cowpox vaccination consists simply in making a wound, scratch or puncture on the human body and then rubbing or injecting into this wound a living or virulent disease virus of a more or less complex nature, usually containing the actual virus of human smallpox combined with animal cowpox and always the virus of pus infection or septicemia in one or more of its many forms. ”

“ Pyæmia is closely allied to septicæmia. It is due to the setting free of bacterial emboli or septic emboli from a broken-down, septic thrombus in the neighborhood of the wound, and the circulation of these emboli in the blood until they are arrested and form the characteristic metastatic abscesses, especially in the lungs, joints, abdominal viscera, and parotid gland. Almost always the source of infection is an infected wound. Granulation does not prevent the occurrence of pyæmia, which, as a rule, commences at a later stage than septicæmia. ”