SCIENCE IN MEDICINE 239 



reference to some of the agents which have been of service in 

 the battle with the germs of disease. 



Chemical Antiseptics. — In the first place there are the chemical 

 antiseptics, such as carbolic acid, corrosive sublimate, iodoform, 

 etc. First introduced into the practice of surgery by Lord 

 Lister, they have widened the scope of operations to an 

 enormous extent. But it is important to realise the action of 

 these potent chemical substances, and the object we have in 

 view in using them. As time goes on it is becoming apparent 

 that aseptic surgery is gradually ousting antiseptic surgery from 

 the field ; and it is very doubtful whether the practice of using 

 antiseptics in the dressing of septic wounds is advisable, since 

 the action of a large number of them, at any rate, is in direct 

 antagonism to the action of the protective substances in the 

 blood, which must be regarded as the prime factors in the art 

 of healing. 



A further limitation to their use in the treatment of bacterial 

 infections arises from the fact that, however readily they may 

 be applied to a local lesion, such as an abscess or a wound, their 

 application in generalised infections has been a matter of 

 extreme difficulty. The administration of the coal-tar deriva- 

 tives and of such preparations as the sulphocarbolate of soda 

 by the mouth has been rewarded with but scant success, and 

 the intra-venous injections of the preparations of formaline, etc., 

 have proved themselves too uncertain and too dangerous to 

 warrant their adoption in practice. 



Success, however, in the treatment of two diseases is to be 

 credited to chemical antiseptics. In the case of Malaria the use 

 of quinine has been attended by brilliant results, and no one 

 would doubt, bearing in mind its method of application, that it 

 actually destroys the malaria parasites which are circulating in 

 the blood. The other disease is Syphilis, in the treatment of 

 which mercury has been so effective. The recent work of 

 Metchnikoff and his fellow-workers at the Pasteur Institute on 

 the relationship of the Spirochceta pallida to syphilis, and on the 

 effect of mercurial inunction after inoculation of the syphilitic 

 virus, is of great importance and interest in this connection. 1 

 Similar success was hoped for in the treatment of acute rheuma- 

 tism with salicylic acid or its salts, but this has unfortunately 

 not been realised. Although these preparations are of the utmost 



1 Harden Lectures, 1906. 



