Vol. XXn. No. 8.] 



POPULAE SCIEN"CE NEWS. 



125 



iReliittne anU fftarmatp. 



PNEUMATIC MASSAGE. 

 A cuKious application of the air-pump, to 

 which the water-pump described in the number 

 of this paper for June, 1887, is particularly 

 adapted, has been devised bj- Dr. Breuillard 

 of France. It is intended as a substitute for 

 the ordinary massage in producing a regular 

 and continuous traction of the skin and sub- 

 iacent tissues. The instruments consist of an 

 elliptical piece of soft rubber, C, with a cav- 

 it}- hollowed out on the under side. Tiiis cav- 

 ity has two small openings, A and B; the latter 

 being prolonged into a tube which connects 

 with a flexible rubber pipe, T. This is attached 

 to an air-pump, V, which may be of any desired 

 pattern, although the water-pump referred to 

 above, which can be attaciied to any water 

 faucet, and is continuous and automatic in 



operation, is to be preferred, from its conven- 

 ience and cheapness. 



To operate the apparatus, the hollow piece 

 of rubber — the ventonse, as Dr. Breuillard calls 

 it — is pressed firmly against the bod}- of the 

 patient, and the air-pump started. When the 

 opening A is closed by the finger, the skin is 

 immediately drawn up by the atmospheric 

 pressure. By removing the finger from A, 

 the pressure is relieved, and the skin resumes 

 its natural condition. The ventuuse is to be 

 moved over the body as the operator desires ; 

 and by replacing or removing the finger over 

 the opening A, the flesh and skin maj* be 

 manipulated to any extent, and in a much 

 more regular and thorough manner than can 

 be done by the hand. The proper amount of 

 pressure to be applied varies in diflferent cases, 

 but the average vacuum should be equal to 

 that of a column of mercury about eighteen 

 inches high, or two-thirds of a perfect vacuum. 

 A pressure gauge is unnecessary, as one soon 

 learns bj- simple observation the proper amount 

 of pressure to apply. The invention is cer- 

 tainly an ingenious one, and may prove to be 

 of great usefulness in cases where a vigorous 

 manipulation of the skin is indicated. 



[Original in Popular Science News.] 

 ANTISEPTIC SURGERY. 



BY JOHN CROWELL, M.D. 



Modern operative surgery has undergone a 

 complete revolution within the last decade. Sur- 

 geons who attained eminence in the palmy days 

 of Mott, Gibson, and Miiter would find with amaze- 

 ment, could they revisit their old arenas where they 

 once held absolute sway, that their favorite methods 

 and theories had been swept away by a new race 

 of operators, with ^raphernalia and manipulation 

 involving the nicest care and discriraiiiation. 



The antiseptic methods now universally accepted 

 by the profession are the results of the Listerian 

 investigations ; and the changes wrought by the 

 adoption of these principles are full of practical 

 interest to all classes, professional and non-pro- 

 fessional For whatever tends to prolong life and 

 relieve suilering, whatever helps man in his strug- 

 gle against disease and in his efforts to restore the 

 wasted energies of the system, becomes of universal 

 importance in the great conserving movements of 

 the human economy. 



Antiseptic surgery is simply based upon a correct 

 observation of a common biological process, — the 

 decomposition of organic substances. Prevention 

 of putrefaction has been practised for ages, and it 

 is only by applying this principle to the treatment 

 of accidental and surgical wounds that the simple 

 story of sepsis and antisepsis is unfolded. 



As a direct sequence of a clear understanding 

 of the nature of their causation, such deplorable 

 results as septicaemia, pysemia, hospital gangrene, 

 and erysipelas have been modified, abated, or 

 radically prevented. 



Every surgeon worthy of the name now takes 

 " prevention " as his watchword, and the success- 

 ful employment of preventive methods has made 

 surgery a conservative branch of the art of healing. 



Antiseptic surgery, then, is simply the preven- 

 tion of sepsis or suppuration, — the result of a 

 wound, whether surgical or accidental. Experience 

 has taught the surgeon that such a wound, however 

 large, will heal without suppuration, provided that 

 the antiseptic precautions are rigidly enforced. 



To an old-fashioned surgeon the nice prepara- 

 tions required for antiseptic surgery seem trifling 

 and superfluous; and he is apt, in the remembrance 

 of his own successes in capital operations, to attach 

 but small importance to the details of precautions 

 made by his younger neighbors. But after wit- 

 nessing one or two of the manipulations by the 

 new method, and after taking careful note of the 

 details of every step, and how that every emergency 

 is covered by the most delicate precaution, he is 

 apt to fall'into line (unless he be obstinate), and 

 generously acknowledge the strong points in the 

 new methods. The requirements of the operator 

 are many, and they must be rigidly enforced. The 

 room should be clean, with no superfluous furniture, 

 and practicalljfcfree from dust. The hands, arms, 

 and nails of the operator must be thoroughly 

 scrubbed, with brush and soap, in hot water. The 

 region of the body to be operated upon must be 

 carefully shaven of hair, and subjected to a thor- 

 ough cleansing; then the hands are to be immersed 

 for at least a minute in a solution of corrosive 

 sublimate. Rings, especially those with stone set- 

 tings, must be removed from the fingers, and the 

 trinkets of nurses mu.st be laid aside. The instru- 

 ments must be minutely inspected, and subjected 

 to a careful cleansing with soap and brush; great 

 care being taken that no dry particles of pus or 

 blood remain in the grooves or handles. These 

 should then be immersed for several minutes in a 

 three per cent solution of carbolic acid, or the one 

 to a thousand solution of the bichloride of mercury. 



Every thing should be disinfected. Whenever an 

 assistant touches an object not disinfected, — a 

 chair or a door, — hands a basin, wipes his face, or 

 scratches his nose, it is absolutely necessary that 

 his hands be scrubbed and disinfected anew. 

 Sponges should be beaten free from calcareous 

 particles, then immersed for fifteen minutes in 

 dilute muriatic acid, to dissolve the remnants of 

 lime, washed in cold water, then kneaded by the 

 hand in pure soap in hot water for five minutes, 

 rinsed, and then immersed in a five per cent .solution 

 of carbolic acid, in which state they are to remain 

 until required for use. Carbolic acid is better for 

 sponges until used, as it does not become decom- 

 posed and inert, like corrosive sublimate. 



When saturated with blood in an operation, 

 sponges must be washed in hot water, then thrown 

 into a basin containing carbolic solution, and 

 handed to the surgeon. 



Catgut prepared after the manner described by 

 Kocher makes the best and safest ligature. 

 Kocher's method is, to immerse the catgut for 

 twenty-four hours in the oil of juniper (from the 

 berry), then preserve in alcohol until wanted for 

 use. Alcohol keeps the catgut soft and phable, 

 while carbolic acid or corrosive sublimate is apt to 

 render them brittle and weak. 



Silk is made un irritant, according to Czerny, by 

 boiling it for an hour in a five per cent solution of 

 carbolic acid, then preserving it in alcohol. 



In perfect antiseptic treatment no drainage is 

 required, for the secretions will become absorbed 

 if they do not contain any thing capable of inducing 

 putrid discharges. Even large blood-clots around 

 a fractured bone will be harmlessly absorbed, and 

 a blood-clot in an aseptic operation will be absorbed 

 without local or general disturbance (Gerster). 

 But in operations where large surfaces are exposed, 

 and where the wound is very irregular, the possibil- 

 ity of even slight contamination should be kept in 

 view, and vent should be provided for by proper 

 drainage-tubes. If the healing is prompt, they can 

 be withdrawn on the fourth or sixth day. 



In the use of lotions, Gerster depends almost 

 exclusively upon carbolic acid and corrosive sub- 

 limate as germicides. They are highly effective, 

 easily obtainable, and simply prepared; and con- 

 stant use has made them, in his hands, thoroughly 

 tested and reliable. 



The modes of dressing are many and varied, 

 according to the nature of the accidental or surgical 

 wound; but they all depend upon the general 

 principle of asepsis. 



Among these methods may be mentioned, as of 

 most importance, chemical sterilization combined 

 with exsiccation, which is included in the dry dress- 

 ing so carefully described by Mackintosh; then 

 there is the simple chemical .sterilization involving 

 the moist dressing. This dress'ing is indicated 

 where rapid absorption is desirable, as in the pres- 

 ence of septic or fetid discharges, when clogging of 

 the drainage is to be avoided. 



The medication of the cheese-cloth or tobacco- 

 cloth gaUze is accurately described in the books 

 under the different forms of corrosive-sublimate 

 gauze and iodoformized gauze. In emergencies com- 

 mon batting or absorbent cotton can be utilized 

 after being well soaked in the corrosive-subli- 

 mate solution, and well wrung out before using. 



All this care and manipulation require hard 

 work. The increase in this respect over the old 

 methods is tenfold, and the attention demanded 

 in dressings and vigilant oversight is vastly more 

 exacting. But results show that the new method 

 is the best. It certainly is based upon a funda- 

 mental principle that cannot be gainsaid by any 

 of the successes that have been attained by the old 

 methods. Older surgeons must not rest content 



