36 WOUND TREATMENT 



tation of wounds." He also shows that even the appli- 

 cation of plain boiled water to the surface of a wound 

 interferes with the integrity of leukocytes and other 

 cells, for under the microscope they are found to swell 

 up rapidly and become completely disintegrated. In 

 summing up his criticism he states that ''the pendulum 

 has swung too far in the direction of the avoidance of 

 antiseptics, and that the reasonable use of all the means 

 at our disposal for securing asepticity of wounds will 

 furnish more constant results." He also adds: ''The 

 chief point to which I take exception is the employment 

 of dressings which do not contain an antiseptic in suffi- 

 cient amount to render the discharges which flow through 

 them unsuitable for the growth of bacteria." When a 

 dressing not containing an antiseptic, although sterile, 

 becomes soaked with discharge, the latter may remain 

 sterile until it comes near the surface of the dressing, 

 but then bacteria will grow into and rapidly spread 

 through it and reach the wound, unless the blood has in 

 the meantime become so concentrated by drying that 

 it is no longer a suitable cultivating medium. 



A second point is the absence of antiseptic solutions 

 during the operation, in which hands and instruments 

 may be washed from time to time to insure continued 

 asepsis. "The attempt to treat wounds without any 

 antiseptics is a very unnecessary complication. In the 

 first place, it is ever so much more difficult to secure 

 asepticity of a wound under such circumstances than 

 if one takes advantage of antiseptics, and in the second 

 place it requires a man who is especially skilled in bac- 

 teriological work, to bear in mind the various loopholes 

 which have to be guarded against in order to obtain a 

 constant aseptic result. ... I confess that- 1 can see 

 no reason for this great dread of a drop of antiseptic ma- 

 terial getting into a wound ; I can only say that my own 



