98 CLINICAL BACTERIOLOGY AND 



Again, it is a deep-rooted idea, and even with men of 

 great practical experience, to go on irrigating sinuses 

 and cavities with antiseptic dressings of considerable 

 strength, their logic being that by so doing they are killing- 

 out the bacteria present in the cavity, and by getting rid 

 of the cause, they reason, the effect — i.e., the disease — will 

 disappear. It requires only a moment's consideration to 

 see that such reasoning is entirely wrong ; nay, more, the 

 facts are not borne out in practice. To begin with, the 

 most vital and active bacteria are not to be found in the 

 debris of an abscess or in the centre of a sinus. Many 

 of them are degenerates, and therefore possess only 

 slight pathogenic powers. Some are devoured by the 

 phagocytes. Others are rendered inert through the action 

 of the antibodies and the poisonous effects of their own 

 toxins. But in the walls of these compartments they 

 are most active and virulent, for there they find what they 

 want — heat, moisture, and nourishment, and last, but not 

 least, removal from their own exotoxins. Now, how far 

 does an antiseptic fluid, such as an aqueous solution of 

 hyd. perchlor., penetrate into the walls of these cavities, 

 which, be it remembered, are varnished all over with the 

 exuded lymph ? Moreover, the mercury salt frustrates its 

 own ends as an antiseptic by coagulating the albuminous 

 lymph and making it a still more perfect varnish. To our 

 mind, there is nothing which detracts more from the healthy 

 healing of a wound, and hampers Nature's efforts so 

 completely, as the repeated use of strong or moderately 

 strong antiseptics. If an antiseptic has to be used, it is 

 much better practice to use one caustic plugging to slough 

 out the germ-laden wall, leaving a healthy granulating 

 surface to complete the repairing process. But even this 

 process has its drawbacks, and must be used with care. The 

 fact of applying dressings strong enough to cause a slough 

 not only causes local death to bring about the slough, but 

 absorption must take place to the surrounding healthy 

 structures, which may be diffused for several inches. All 



