SURGERY. 



747 



cose." After clarifying, the liquid is concen- 

 trated in vacuum-pans and is decolorized with 

 bone-black. Starch-sugar is chiefly used in 

 making table-sirup, in brewing beer as a sub- 

 stitute for malt, and in adulterating cane-sugar. 

 It is also used to replace cane-sugar in confec- 

 tionery, in canning fruits, in making fruit-jel- 

 lies, and in cooking. Artificial honey is made 

 with it, and so also is vinegar. In response to 

 a request by the Commissioner of Internal 

 Revenue, in regard to the status of glucose, the 

 following statement was prepared by the Na- 

 tional Academy of Sciences: 



That the manufacture of sugar from starch is a long- 

 established industry, scientifically valuable and com- 

 mercially important. 



That the processes which it employs at the present 

 time are unobjectionable in their character, and leave 

 the product uncontaminated. 



That starch-sugar thus made and sent into commerce 

 is of exceptional purity and uniformity of composition, 

 and contains no injurious substances ; and 



That though having at best only about two thirds 

 the sweetening power of cane-sugar, yet starch-sugar 

 is in no way inferior to cane-sugar in healthfulness, 

 there being no evidence before the committee that 

 maize-starch sugar, eitherjn its normal condition or 

 fermented, has any deleterious effect upon the system, 

 even when taken in large quantities. 



Sorghum-Sugar. Since 1878, considerable in- 

 terest has been developed in the cultivation of 

 sorghum (Sorghum vulgare) for the production 

 of sugar. Largely through the influence exerted 

 by the Chemist of the Agricultural Department 

 at Washington, numerous experiments were 

 made, all of which have tended to demonstrate 

 the practicability of obtaining sugar from this 

 source. Only estimates of the quantity an- 

 nually produced are available. The following 

 works are in active operation: The Yates 

 County Sugar Company, at Penn Yan, N. Y. ; 

 the refineries at Rio Grande, N. J. ; at Cham- 

 paign, 111. ; at Stirling and at Hutchinson, Kan. 

 At the last four the production during 1883 is 

 said to have exceeded 200,000 pounds each. 

 At Dundee, Kinsley, and Lawrence, Kan., are 

 works whose out-put was about 10,000 pounds 

 each ; making a total of 830,000 pounds. 



SURGERY. Antiseptics. The whole practice 

 of surgery has undergone a radical change 

 during the past few vears, because of the in- 

 fluence of the germ theory of disease. This 

 theory the theory of Pasteur may be briefly 

 stated as follows: "Wherever there is de- 

 composition of an organic liquid or solid sub- 

 stance, such decomposition is caused by the 

 physiological action of living beings, the germs 

 of which pullulate in the air. Wherever a 

 wound is made, air penetrates, and, with the 

 air, germs, which have the power of develop- 

 ing themselves, even in the interior of blood- 

 vessels, where the circulation carries them. 

 Hence result inflammations of the lymphat- 

 ics and of the veins, erysipelas, gangrene, etc. 

 The more cutting the instrument with which 

 the operations are performed, the more freely 

 are the vessels divided, the better do the germs 

 penetrate, the more easily do microphytes and 



microzoa cause complications, especially in loose 

 and vascular tissues." 



This theory for it is still a theory though 

 it met with little favor in the country where 

 it originated, was unhesitatingly adopted by a 

 distinguished British surgeon, Mr. Lister, and 

 by certain leading German surgeons Volk- 

 mann, von Nussbaum, and Konig and the 

 practice based upon it has added a new word 

 to surgical literature. " Listerism " is the 

 practice of Mr. Lister, based upon his accept- 

 ance of Pasteur's theory of the origin of many 

 surgical diseases. It consists in a systematic 

 endeavor to prevent the access of air, ami 

 therefore of germs contained in the air, into 

 wounds ; and to destroy any germs which may 

 have entered. Carbolic acid was the germi- 

 cide upon which he placed his main reliance, 

 and all wounds were immersed in it, and all 

 operations were performed in its vapor instead 

 of in the air. The most essential part of every 

 operation became a spray - apparatus, which 

 should surround the tissues to be operated 

 upon with a vapor of carbolic acid. The sur- 

 geon himself, his assistants, the instruments 

 used, everything which could possibly convey 

 a microscopic germ into a wound, was thor- 

 oughly impregnated with the germicide, and 

 after this the wound was dressed with an 

 absolutely impermeable complicated dressing 

 composed of many layers of different materi- 

 als, each adding to the wished-for result the 

 avoidance of the entrance of air. When it 

 became necessary to open a wound which had 

 once been dressed, the same elaborate perform- 

 ance was repeated, and the part could only be 

 inspected and examined under a covering of 

 carbolic acid, either in the form of a solution 

 or of spray. This is what is now understood 

 by antiseptic surgery, by Listerism, and this 

 it is that has to so great a degree modified the 

 surgery of the day. The practical details of 

 the treatment have been modified from time 

 to time ; other antiseptics, such as the bichlor- 

 ide of mercury, thymol, and eucalyptol, have 

 been substituted for carbolic acid; the dress- 

 ings have been changed in various ways, both 

 by Mr. Lister and his followers, but the essen- 

 tial features of the treatment remain. 



In this article we have to deal rather with 

 the antiseptic treatment of wounds than with 

 Pasteur's germ theory upon which it rests. 

 Good practice may result from false theory, 

 and Mr. Gamgee is not alone when he says : 

 "That infection is always floating in the at- 

 mosphere, ready to settle, in the shape of im- 

 palpable and implacable germs, into any breach 

 which may be made in the surface of a living 

 body, is an idea which has never troubled uie. 

 The prescription, inspired by that idea, to rub 

 strong carbolic acid into the innermost recesses 

 of a compound fracture, to pursue and kill the 

 germs ; the warning that an antiseptic dressing 

 may lose all its potency through a hole no big- 

 ger than a pin's point, in the investing Mackin- 

 tosh, admitting countless germs; that a dress- 



