Antiseptic

“ The action of micro-organisms is often combated directly by the introduction into preserved foodstuffs of such antiseptic substances as boric and salicylic acids and formaldehyde. They are considered injurious, however, and their use is forbidden by law in many States. Besides the antiseptics proper, a number of the more common substances, such as connnon salt, sugar, alcohol, and saltpetre, are used in food preservation. On the other hand, antiseptics are used for other purposes besides the preservation of foodstuffs. ”

“ Glyco-Thymoline conflicts with Rule 1 of the Council on Pharmacy and Chemistry, which declares that no article shall be accepted for inclusion with New and Nonofficial Remedies unless its composition be furnished.
2. No matter which published formula be accepted as correct, it is at best a weak antiseptic. The antiseptic ingredients present cannot act as germicides in the strength in which they are used, or in the alkaline solution on the unique virtues of which the circular lays so much stress (“the one antiseptic solution based on the alkalinity and saline strength of normal blood”) . ”

“ Can we so diffuse the vapor of an antiseptic like carbolic acid through the air as to destroy the germs which are floating in it, and thus purify it, making it like air which has been filtered through wool, or like that on the top of a lofty mountain? If the smoke of a wood fire seems to act as an antiseptic, and putrefaction is prevented, it seems reasonable to conclude that air could be purified and made antiseptic by some proper and convenient arrangement. Let us endeavor to test this by a few experiments. ”

“ 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. ”

“ Doctors, for instance, use antiseptic instead of disinfecting solutions on wounds, not because they do not wish to kill the pus-forming bacteria, but because the antiseptic solution will prevent their growth and not be, as a disinfecting solution, harmful to the cells which he is trying to repair. It would be folly, for example, to inject a strong 50 per cent solution of carbolic acid into a wound on the arm produced by a saw, because all the energy of the vital forces at the seat of the wound are needed for repairs, and there is none to spare for so active a detergent as carbolic acid. ”

“ An antiseptic prevents putrefaction but does not necessarily destroy the microörganisms. A substance may act as an antiseptic by delaying or preventing the processes of decay and decomposition, but still not be a germicide. ”

“ The best practical antiseptic for sanitary purposes is cleanliness; the best disinfectants are heat, bichloride of mercury, sulphate of iron, chloride of zinc, sulphurous acid, chlorine, sunlight, and pure air, and, for yellow fever, cold. With our present very imperfect knowledge of the nature of specific causes of disease which we wish to destroy, we have no means of determining the presence of these causes in or on an article of clothing or of furniture, or in a room or other locality, except by the production of their specific effects on man or by inductive reasoning ”

“ The truth is that the spray was only one of many devices tried for a while in the course of the long-continued endeavour to apply the antiseptic principle to the best advantage, and abandoned in favour of something better. Two main objects were always kept steadily in view by him—during the operation to guard the wound against septic microbes by such means as existing knowledge indicated, and afterwards to protect it against their introduction, avoiding at the same time all needless irritation of the tissues by the antiseptic. ”

“ The cause of pus formation in wounds is usually the presence of germs. For this reason the utmost care should be adopted to keep clean wounds aseptic, or free from germs, and to make unclean wounds antiseptic by using antiseptic fluids to kill the microbes present in the wound. The less the injurious action of this fluid on the wound and the greater its power to kill germs, the more valuable it becomes. All antiseptics are not equally destructive, and some germs are more susceptible to one antiseptic than to another. ”

“ Lister said, in a communication to the Royal Society of Edinburgh made in April, 1873, "it would be needless to provide an antiseptic atmosphere in carrying out the antiseptic system of treatment; and all that would be requisite in the performance of a surgical operation would be to have the skin of the part about to be operated upon treated once for all with an efficient antiseptic, while the hands of the surgeon and his assistants and also his instruments were similarly purified ”

“ Many practitioners lose sight of the essential difference between antiseptics and disinfectants and employ antiseptics in cases in which only a disinfectant action would be of value. An antiseptic does not destroy bacteria, it merely inhibits their growth; and when it is diluted too much, it loses its effects and the bacteria may begin to multiply as though no antiseptic had been used. ”

“ As years went on, surgeons tried to simplify and improve the somewhat complicated and expensive measures and dressings and chemists were at pains to supply carbolic acid in a pure form and to discover new antiseptics, the great object being to get a non-irritating antiseptic which should at the same time be a powerful germicide. ”

“ It was in the course of 1888 that operating surgeons began to neglect the letter of the antiseptic treatment and to bring themselves more under the broadening influence of its spirit. Certain adventurous and partially unconvinced surgeons began to give up the carbolic spray gradually, by imparting a smaller percentage of carbolic acid to the vapour, until at last the antiseptic disappeared altogether, apparently without detriment to the excellence of the results obtained. ”

“ In practice no substance acts entirely as an antiseptic as the organisms present have varying degrees of resistance and the less viable ones are killed by doses that are only antiseptic to the more resistant ones. An example of an antiseptic effect followed by a mild disinfectant action, caused by small doses of bleach is shown in Table XV. In this experiment the water designated as control was from the same source as the treated water. ”

“ While an antiseptic agent is not necessarily a disinfectant, all disinfectants are antiseptics; for putrefactive decomposition is due to the development of germs of the same class as that to which disease-germs belong, and the agents which destroy the latter also destroy the bacteria of putrefaction when brought in contact with them in sufficient quantity, or restrain their development when present in smaller amounts. ”

“ It is in this condition of the system that this medicine, by its powerful antiseptic properties, manifests its most wonderful curative ability. When, as in this disease, the vital forces of the system have, in a degree, lost their restraining influence over the processes of disintegration, waste, and decay, which goes on so rapidly that nutrition cannot compensate for the loss to the system, then it is that the "Golden Medical Discovery," by its antiseptic influence, checks this rapid waste of the tissues, and thus arrests the disease. ”

“ An inefficient antiseptic is more than merely useless; it is a menace to public safety, in that it tends to lead to the neglect of rational and effective protective measures. It therefore seems advisable for the Council again to call the attention of physicians to the subject. Accordingly, three specimens of these products were purchased and examined in the Association’s Chemical Laboratory. ”

“ 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. ”

“ If warp or cloth is sized or finished damp, then stored in a dry room for a considerable time, mildew may be expected, unless antiseptics have been used. An antiseptic is a substance tending to destroy vegetable life, and of antiseptics muriate of zinc and carbolic acid are the most suitable for sizing [37] purposes. As chloride of magnesium does not prevent mildew, indeed, its use being rather favourable to the development of that evil, the name anti, or antiseptic, usually given to it is misleading. ”

“ Therefore the antiseptic he is seeking is one that will assist the serum in protecting and repairing the broken tissues and will kill the hostile bacteria without killing the friendly phagocytes. Carbolic acid, the most familiar of the coal-tar antiseptics, will destroy the bacteria when it is diluted with 250 parts of water, but unfortunately it puts a stop to the fighting activities of the phagocytes when it is only half that strength, or one to 500, so it cannot destroy the infection without hindering the healing. ”

“ Some manufacturers began in an experimental way several years ago to put up these goods without antiseptics, and several of the large firms announce that the antiseptic is no longer necessary if the product is properly sterilized and packed in a small package. Others contend that an immediate prohibition of antiseptics will destroy their business. ”

“ But these excessive refinements do not seem to be generally acceptable, whilst the results of practice show that they are by no means necessary. The careful, the antiseptic surgeon of 1885 is to-day represented by the careful, the aseptic surgeon. The antiseptic surgeon was waging a constant warfare against germs which his creed told him were on his hands, in the wound, in the air, everywhere—and these he attacked with potent chemicals which beyond question often did real damage to the healthy tissues laid bare during the operation. ”

“ A disinfectant is usually described as a substance capable of destroying bacteria and other micro-organisms, and an antiseptic as one that restrains or retards their growth or reproduction. This distinction is entirely arbitrary as the ability of a substance to kill organisms or merely inhibit their growth depends upon the concentration employed. ”

“ If the subcutaneous tissue is affected and the surface indicates the breaking down of tissue, hot antiseptic applications are advisable or the skin is incised down to the deep fascia at such places and iodoform gauze is packed into the wound for several hours. Constant antiseptic irrigation is then established by means of drainage tubes inserted into the various incised places, which are connected to an irrigating apparatus, so that the antiseptic may reach all parts of the infected area. ”

“ A disinfectant destroys the organisms, and at the same time removes the noxious products of fermentation and putrefaction. The conditions which favor putrefactive change are a moderate degree of warmth, air, and the presence of moisture and microorganisms. Measures which tend to limit the action of any of these agencies are antiseptic in character. Cold acts as an antiseptic, by bringing the article to be preserved to a temperature at which the putrefactive bacteria can no longer act. In the preservation of canned goods another principle is employed, that of exclusion of air. ”

“ Any agent which is used to destroy microörganisms is called a “disinfectant.” Material freed from living organisms is “sterile.”
The process of preventing the growth of organisms without reference to whether they are killed or removed is spoken of as “antisepsis,” and the agent as an antiseptic. Hence a mildly applied “disinfectant” becomes an “antiseptic,” though it does not necessarily follow that an “antiseptic” may become a disinfectant when used abundantly. Thus strong sugar solutions prevent the development of many organisms, though they do not necessarily kill them. ”

“ From the above findings we conclude that Tyree’s antiseptic powder is a mixture of boric acid and dried zinc sulphate and antiseptic bodies, such as menthol, salicylic acid and carbolic acid, eucalyptol, etc. From this it can be readily seen that the label, which is supposed to set forth the composition of Tyree’s antiseptic powder, is not in accord with the facts. The powder does not contain either borate of sodium or alum, and the presence of glycerin could not be established. The antiseptic agents, exclusive of the boric acid, are present only in small amounts. ”

“ The antiseptic agents employed must be sufficiently potent, and persistently applied 11to render the surface sterile and yet not so caustic as to destroy more tissue to become a future culture medium for the septic microbes. ”

“ The daily bath should be continued, and there is no objection to its being made antiseptic by the addition of carbolic acid or bichloride of mercury. It is simpler and safer, however, to employ a plain bath and to disinfect the skin later by sponging with some antiseptic lotion, such as peroxide of hydrogen or permanganate of potassium. ”