INFLAMMATION 243 



teria have found lodgment and have become established, then we 

 have to deal with the invasive power of the organisms on the one 

 hand and the factors of resistance of the body on the other. To 

 Wright we are considerably indebted for his contributions to this 

 particular field and Flemming has discussed the subject in a compre- 

 hensive manner in a recent paper. 



According to his view the role of antiseptics in the treatment of 

 wound infection is problematic. Flemming believes that all solutions 

 that are at all effective have no appreciable bactericidal titer in the 

 wound, but that they act as mild tissue irritants leading to increased 

 leukocytic emigration and to more abundant flooding of the wound 

 with normal tissue fluids, in this way hastening the separation of 

 sloughs and the elimination of bacteria. He regards the antiseptic 

 method of Dakin and Carrel, for instance, as fundamentally dependent 

 on the same principles as that of the so-called physiologic method of 

 Wright. 



It is quite apparent from his study that both the leukocytes as 

 well as the enzyme-antienzyme content of the blood serum and tis- 

 sue fluids have considerable bearing on the healing of wounds. 



Application of these principles was made by Wright in the use of 

 hypertonic salt solutions (clinically not successful to the degree an- 

 ticipated, because of the discomfort to the patient) ; the use of concen- 

 trated sugar solutions; and the use of nonpathogenic bacteria which, 

 when introduced into the wound, seemed to have a favorable effect 

 on inflammation. The so-called "Reading" bacillus seems to have 

 been one of the most successful of the bacteria of this type. This 

 was a spore bearing anaerobe of saprophytic nature, to which the 

 name "Reading Bacillus" was given by Donaldson. He describes it 

 as follows: 



"It is highly resistant to heat and drying, and grows best in a 

 slightly alkaline medium. It most closely resembles B. sporogenes 

 (Metchnikoff) . It is nonpathogenic for animals as well as for man 

 when introduced into septic wounds. It does not attack living tis- 

 sues. The use of salt is not necessary for the successful treatment 

 of gunshot wounds, as was thought by those who advocated the salt- 

 bag method. The success depends rather on the activity of this 

 particular bacillus under conditions favorable to its growth and not 

 on the salt. The rationale of the method depends not on inhibition 

 by the Reading bacillus of the growth of pathogenic organisms in the 

 wound either by reason of the formation by the bacillus of an in- 

 hibitory organic acid, or by the production of any bacteriolytic fer- 

 ment. It acts, however, by virtue of its proteoclastic enzymes as an 

 organic catalyst which hydrolyzes the substrate of dead protein. It 

 disintegrates the protein base from which pathogenic organisms oper- 

 ate, and while so doing does not itself give rise to fresh toxic sub- 

 stances. Not only so, but it is probably able to hydrolyze also the 



