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Antiseptics.

BY DR. E. M. GLESSNER, WILCOX, NEBRASKA.

READ BEFORE THE SOCIETY OF SURGEONS OF ST. JOSEPH & GRAND ISLAND, ST. JOSEPH, MO., FEB. 23, 1895.

T would be a difficult matter to write an article on antiseptics without eulogizing the great French savant, Pasteur, the most interesting character who figures in modern medical progress today. Unlike so many great men, Pasteur, at the age of 73, still lives to enjoy the distinction given him, by his labors and discoveries. He it was who first made it possible for aseptic and antiseptic treatment to be applied to surgery, with all their brilliant results.

The work done by Pasteur is immense. In his investigations he touched upon the various branches of physical, natural and medical science; but what raised him to first rank were his studies on spontaneous generation, on lactic, tartaric and alcoholic fermentation. His essays on these subjects were published about 1866. In 1894 his immortal work on rabies, its prophylactic and curative treatment was published. In the meanwhile he had discovered the artificial attenuation of virus, and had applied this method to the preventive treatment of carbuncle and hen cholera. The medical and surgical section of the Academy of Science gave Pasteur a celebration on the 70th anniversary of his birth. He was heard to say on this occasion: "Imagine what hope possessed me when I first had a presentment that there were laws behind so many obscure phenomena." The first link of the chain was the discovery of animated germs. He showed that these germs were not spontaneously produced; that they people the atmosphere and the bodies that surround us. If by boiling or dry heating a solid or liquid body is rid of the germs it contains, it becomes sterilized, and remains sterile and unaltered as long as it is kept from the air; but as soon as air is brought in contact with it germs are developed and destroy its sterility. These germs come from the surrounding atmosphere. Pasteur proved the identity of the germs found in the air with the germs in the bodies experimented on. He proved these germs existed in the air, by sterilizing the air and then bringing it in contact with the sterilized bodies, with the result that the bodies regained the same. It is said that for more than 20 years there have been preserved at the Pasteur Institute, some of the flasks used in this wonderful experiment. The liquid they contain remains. pure and limpid.

Spontaneous generation was exploded. Pasteur had established definitely the presence of the micro-organisms, over whose existence learned

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men had disputed for centuries. Today we all know these facts, and like the egg of Christopher Columbus (that no one could make stand on end), it is easy enough to understand after being shown how. By cultivating these germs, and liquids adapted to them, studying their development and biological conditions, and following their mode of life, Pasteur created in all its main features a new science, bacteriology. The result of this discovery was his theory of fermentation. He proved that organic putrefaction does not, as was believed, result from purely chemical action, but is determined by the intervention of living germs, by the development and life of inferior micro-organisms. After this we have Pasteur's experiments on wine, vinegar and beer, direct applications of the doctrine of living germs. Later his discovery of the attenuation of virus. He succeeded in artificially varying the virulence of these germs, increasing or diminishing it at will, then taking the attenuated virus and injecting it, he rendered the animal so treated refractory to the disease, thus finding in the very evil its own remedy. This discovery with its benefits was applied to carbuncle and hen cholera.

The logic of this method led him step by step to man himself. To Pasteur has reserved the glory of proving that in the human body also, living germs are the cause of transmissable and contagious diseases, and of applying to human ailments his theory of the attenuation of virus, thus preventing disease and even stopping it in its evolution when already at work in the human organism.

Medical science has been more largely benefited by these discoveries than any other science. A revolution has taken place in medicine, the scope of which can not be measured. By proving that the penetration and multiplication of living germs is the necessary cause of contagious diseases among human beings, Pasteur, at the same time, pointed out the remedy. Thanks to him, the physician can, by means of suitable antiseptics, fight micro-organisms, arrest their development, destroy them, and consequently cure the disease they had caused. If success does not always crown his efforts the reason of this is not in the method, but in the facts that for each microbe must be found an antiseptic that most quickly and certainly destroys it; that it is not always easy to have the remedy reach the seat of the disease; that in the endeavor to destroy the microbe care must be taken not to destroy the patient, for in a human body things can not be done as in experiment, therefore, there are still considerations, uncertainties, failures. The perfecting of the method must still be left to the future. Bacteriological science is still in its infancy, but the results obtained are full of encouragement. It is due to this method that the con

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tagion of infectious diseases can today be averted. Isolation and disinfection will accomplish this. Epidemic plagues can be checked in their march of terror and stamped out in the place of their origin. The terrible epidemics that have so often devastated cities and countries, and driven people terror stricken from their homes may, in the near future, be blotted out. By the application of this method through a system of quarantining, whole countries, continents, have been protected against dreaded epidemics. The terrible complications caused by erysipelas, septicemia, purulent infection in our large hospitals is a thing of the past. Obstetrics especially, in hospitals, has been reformed; now we no longer hear of the innumerable cases of puerperal infections.

Lister, the famous English surgeon, was the first to make application of these principals to surgery; he was the first to apply to surgery the germ theory, to dress wounds with antiseptic applications, the first to praise and recommend asepsis and antisepsis.

At the present time Drs. Behring and Roux (after the same method almost, that Pasteur used in curing rabies), are perfecting a process for curing diphtheria by the injection of antitoxine. In fact, it is now a success. And now as I stop to reflect, while believing in these theories, I wonder how many of us can, in a general practice, carry out the rules and regulations of a thoroughly antiseptic treatment. We attempt to, but do we carry it out? Take, for instance, a compound fracture, occurring in a railroad injury, with grease, clothing and dirt crushed into skin, muscle and bone, points of bone denuded of their periosteum, etc., you cannot wash this off; you must pick it off, cut it off, use your strong antiseptics to make it aseptic. Perhaps you get it aseptic; perhaps you do not. Your result may be good. That does not necessarily argue that your sublimated washes, etc., have procured this result. In every case we all know that nature throws out a serum over this crushed surface, that acts aseptically, and protects it as if coated with collodion. It has at least taught us cleanliness, which is next to godliness, and we now wash our hands and clean our finger nails before an obstetrical case, as well as after. If it is true that our surrounding medium (the air) contains the infecting material (the germ) how many thousand do you think one of our Nebraska palaces (a sod house) would contain, with walls and surroundings that it would be well nigh impossible to sterilize. How many of us have greasy colleages in the country who, I am sure, never made an attempt to be aseptic since they left the protecting care of a godlike mother. Understand me, I do not discourage the attempts. to do all one can in this direction, but I am reflecting and thinking how impossible it is to enforce, in a general practice, these methods. Many a

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time are we called to places where four days of fumigation and ten hours scrubbing would not begin to put things in an aseptic condition. And I sometimes think, too, that matters are carried to an extreme, for instance, when the Philadelphia County Medical Society, of Pennsylvania, passed resolutions recommending the adoption by churches, of the individual communion cup, as a prophylactic measure against the transmission of contagious diseases. I also, am almost afraid to drink milk for fear I contract tuberculosis from the tubercle bacillus that may be in the milk derived from the cow; then, again, I think mucus has microbicide properties which is capable of destroying all kinds of microbes. Also the nasal mucus is a germ destroyer, and when that milk reaches my stomach I am again protected. The gastric juice, which is an antiseptic fluid and a germ destroyer, (which will remain unchanged for months, exposed to air) will stand as a sentinel against disease. Nature in all lavishness, has protected us; we are fearfully and wonderfully made, and if you, my dear doctors, will stop to think, there is not a single inlet or outlet of the body that is not protected by antiseptic secretions or excretions, and maybe they do more for us than all our boasted knowledge. And that brings to my mind a story entitled, "What are we coming to:"

Public school A. D. 1905: Teacher, to applicant for admission, Johnny, have you got a certificate of vaccination for small-pox? Yes, sir. Have you been innoculated for croup? Yes, sir. Been treated with diphtheria serum? Yes, sir. Had your arm scratched with cholera bacilli? Yes, sir. Have you a written guarantee that you are proof against whooping cough, measles, mumps, scarlet fever and old age? Yes, sir. Have you your own private drinking cup? Yes, sir. Do you promise not to exchange sponges with the boy next to you and never use any but your own pencil? Yes, sir. Will you agree to have your books fumigated with sulphur, and sprinkle your clothes with chloride of lime once a week? Yes, sir. Johnny you have met the first requirements of the modern sanitarians, and you may now climb over yonder rail, occupy an isolated aluminum seat, and begin making p's and q's as your first lesson.

This story only tends to show apt doctors are to ride a hobby, and like other people run after a fad. Hoping I have not grown tiresome, I will read

you a few verses, and close.

The R. R. surgeons of the G. I. and St. Joe
Have formed a society, which they propose to make go.
They meet in conclave, about twice in the year,
To let each other their wise papers hear.

Perhaps there is more than this they meet for,
A desire for knowledge may knock at the door,
Humanity, I guess is at the bottom of this.
To give our poor patients a chance for less risk.

Here we meet brimful of medical lore,

And rant and cant till we almost slop o'er,

Our minds are abused and disabused

Of too many old methods, and the drugs we've used.

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As to our homes once more we speed

Our minds are full of the unknown deeds,

We'll perform on the fellows who break their heads
Making their living over these roadbeds.

We continue to think how it is

We're down here on this kind of a whiz,

Who's made it possible for us, in high dudgeon
To be wearing the title of Railroad Surgeon.

E. S. Garner, our manly young chief,
Has not been unmindful or even deaf,

Of the fast advances of the present day

He is right in the push on the broad highway.

He has made it possible for the car break twister

To have his wounds dressed according to Lister.

Here's success to our revered young boss,

Who thinks, my dear boys, on your backs you'll find moss.

Chloral Hydrate.

DR. W. R. PENNINGTON, M. D., BEATTIE, KANSAS.

READ BEFORE THE SOCIETY OF SURGEONS OF THE ST. JOSEPH & GRAND ISLAND RAILROAD, ST. JOSEPH, MO., FEBRUARY 21ST, 1895.

ENTLEMEN:-My reason for selecting this article for my subject today is that there is so little said through the medical journals about it. Though discovered over forty years ago, this compound has but recently attained attention as an anesthetic agent, having been first brought before the Medical Society in Berlin, in the year 1869, by Dr. Lubrich, of that city.

It results from the action of chlorine on alcohol, the latter of which gives up five of its six equivalents of hydrogen to the former, producing five equivalents of muriatic acid and combines in their place with three equivalents of chlorine to form the substance in question.

It has been inferred by Dr. Lubrich that when taken into the circulation where it meets with soda, it undergoes decomposition, one of the results of which is the formation of chloroform, so that it is not the chloral itself, but the chloroform which really operates, and the fact is that the symptoms following the exhibition of chloral are similar to those which characterize the action of chloroform.

In the Medical Century of September, 1869, is an account of a case of delirium tremens treated by giving chloral in full doses, after morphia and other narcotics had failed.

About 70 grains was given by the stomach, dissolved in water, and in 25 minutes afterwards another gramme was administered; in 5 minutes the patient went to sleep.