48 Colonel Sir Almroth E. Wright [March 9, 



Let me show you a set of typical results o1)tained by the test- 

 procedures just described, using Dakin's antiseptic, to-day perhaps 

 the most popular of all antiseptics. 



In Tube 1 we have obtained, as yon can see l)y these sub-cultures, 

 complete sterilisation. And it was obtained after only momentary- 

 contact with the antiseptic. In Tube 2, where a lightly infected 

 serum was shaken up with an equal bulk of the antiseptic and then 

 incubated, we have^in our mixture of serum and antiseptic a very 

 vigorous growth of microbes. You see the medium has become 

 turbid, and there has been an evolution of gas which has pushed 

 up the plug of congealed vaseline. In Tube :> — and here the anti- 

 septic stood for four hours in the tube — we have in the barrel a teem- 

 ing multitude of microbes. And in Tube 4, after four hours' contact 

 with the antiseptic, only that very thin layer of the infected lining 

 which coats the barrel lias been sterilised, in the depth of every spike 

 the bacterial colonies have come up quite thickly, and only in 

 immediate contact with the antiseptic have the microbes been 

 killed. I here show you also in a companion tube which has been 

 incubated 24 hours longer that the microbes you have seen growing 

 in the deeper layers very soon penetrate the sterilised superficial 

 layer, and grow out in the culture medium in the barrel of the tube. 



When we find an antiseptic giving results quite different from 

 those here displayed it will then, for the first time, become a rational 

 programme of operations to use, and leave behind, an antiseptic in 

 a wound with a view to safeguarding the patient during lengthy 

 transport. 



Suggestion that the bacterial infection in the wound can be kept 

 doivn during transport by frequent re-appJications of an antiseptic. — In 

 the earlier period of the war the only method of re-applying an 

 antiseptic was that of taking down the dressing, syringing the wound, 

 and completely re-dressing. That was, especially in the case of 

 deep wounds and compound fractures, a very lengthy and painful 

 procedure, and one which was nearly impractical )le in transport. For 

 that complete re-dressing there has now been sul)stituted by Carrel a 

 procedure for washing and refreshing the surface of the wound 

 through rubber tubes. According to Carrel, Dakin's antiseptic 

 should be employed, and this should Ije applied every two hours. 

 About the application of this in transport let me say this : that it 

 would, I think, l)e impracticable to carry it out on a sufficiently large 

 scale and sufficiently systematically ; and Dakin's antiseptic applied 

 in an unsystematic manner gives exactly the same results as simply 

 keeping the wound wet. 



Suggestion that the set-back in the wound during transport could be 

 prevented bg dressing with hypertonic salt solution. — The set-back in 

 the wound with its resulting tragedies could, I think, be avoided by 

 drawing out lymph in a continuous manner from the tissues, and 

 holding up the emigration of leucocytes. Tbe outflow of lympli 



