Licence: Public Domain Mark
Credit: The surgery of the head and neck / by Levi Cooper Lane. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![XXVlll INTRODUCTION named protective. The Listeriaii method was rapidly adoi)ted by the younger generation of surgeons; but numerous modifica- tions of it soon appeared, promineut among which was the abandonment of the spray in which Lister did liis early opera- tions. Instead of carbolic acid, salicylic acid, and boracic acid were employed to impregnate the material used for dressing. Chloride of zinc in solution was likewise used. Sternberg deserves great credit for what he has done in the development of Bacteriology; he tested the germicidal power of the various antiseptic agents, and found that corro.sive sublimate is remark- able for its anti-bacterial properties. As the result of the investiga- tions of Sternberg and others, corrosive sublimate has come into general use in both aseptic and antiseptic surgery. It is used in dilution varying in strength from a solution of one part in one thousand parts of water to one in ten thousand parts of water; the usual dilution is that of one in two thousand. In operative work done antisepticall}', the surgeon disinfects the part to be operated on, also his hands and instruments; and this disinfection is done with a carbolized, sublimated, or other antiseptic solution. It was the custom, in the early days of antisepsis, to flush the wound with the antiseptic solution; but the antisepticijui has modified this part of his work, and instead of active chemical solutions, he uses sterilized water for flushing the wound. In thus doing, the operator avoids the irritation of the wounded j^arts wliicli results from the application of carbolic acid, corrosive sublimate or other chemical irritant. A few surgeons in operating closely follow the antiseptic metliod as first ]>ursued by its author; more deviate widely from it, and have adopted a procedure known as tlie aseptic. Asepsis is the offspring of antisepsis. Asepsis is Listerism simplified. In aseptic work, germicidal chemicals are withheld from the wounded structure. To do an operation asepticall}^ the surgeon's hands should be absolutely clean, his operating dress clean through sterilization, his instrnments purified, the surface to be operated on must be purified from bacteria and their derivative toxins. And finally, the work being done, a dressing must be applied which will exclude every infective agency. To cleanse the hands and forearms let them be scrubbed well with Castile or green soap and water, which has been sterilized by boiling. A brush which has been sterilized by immersion in chloroform, alcohol, or turj)entine must be used on the nails, fingers, and hands. The hands should then be rubbed with alcohol, and, lastly, immersed in a solution of sublimate. An- other plan, after the hands have been cleansed with soap and water, is to immerse them in a solution of permanganate of potash, then to decolorize them in a solution of oxalic acid, and to conclude by immersing them in a solution of sublimate. Another plan is to take equal parts of chloride of lime and carbonate of soda, and having made a paste of them to rub tliis](https://iiif.wellcomecollection.org/image/b21215406_0032.jp2/full/800%2C/0/default.jpg)
