SURGICAL ANTISEPSIS AND ASEPSIS. 49 
France, and by Wolkmann and Billroth in Germany, soon became 
‘ popular in every country. Everywhere it took the place of the old 
ones ; but, advantageous as it was, it wag soon found to have many 
faults ; such as, its many details, and the time required to apply it, 
its expensiveness, and the toxicity of the phenic acid. Everywhere, sur- 
geons set about improving it, and above all simplifying it, while re- 
specting the principal rules established by its author. For phenic 
(phenol) acid, Thiersch substituted salicylic acid; Lewin, thymic 
acid ; Kocher, chloride of zinc and sub-nitrate of bismuth ; Bergmann, 
corrosive sublimate ; Mosetig-Moorhof, iodoform. The phenicated 
gauze was replaced by rough netting (gauze) kept in phenol (weak 
solution) until ready to use (Bardeleben), and by muslin soaked for 
a week in a strong phenic solution (Boeckel). Neuber proposed to 
use for drainage, tubes made of decalcified bones, which would be 
resorbent, irritate the tissues but little, and avoid the too frequent 
renewal of the dressing. The profectve band was recognized as 
useless, and drainage was used only when it was pretty evident 
that immediate reunion would not take place. The technic of the 
dressing, the microbicide agents, and the strength of the solution, 
were all changed indefinitely. 
Guerin, holding to the principal idea resulting from the new doc- 
trine, prevented the entrance into the wound of the germs of the 
air. Hewas less occupied with the infection through the hands, 
instruments and objects of dressings; and if he nevertheless ob- 
tained good results, he owed them in a great part to ‘‘ cleanliness,” 
to an excellent habit which he had, before working, of washing his 
hands and cleaning with soap and camphorated alcohol the region 
to be operated upon and its surroundings. 
Lister’s method was more sure, but it also had its imperfections 
and its errors. Evidently the success which marked the beginning 
of antisepsis was not exclusively due to phenic acid. To it was at- 
tributed a vigorous bactericide action that it did not possess. The 
belief in rapid and complete disinfection, by phenicacid, of the in- 
struments, hands, and operative field were fallacious. In the pro- 
cess of Lister, asin that of Guerin, what was important was the 
severe cleanliness of the hands, instruments, and objects of dress- 
ing. Notwithstanding phenicacid, say Terrillon and Chaput, ‘ an- 
tisepsis would never have come out of its limbus if cleanliness had 
not helped it to make its entrance into the world.”? 
Protect the wounds from the action of the germsof the air. Such 
was the great occupation of Guerin, and of Lister himself. But. 
numerous observations have shown that infection of wounds is. 
almost always produced by the hands of the operator or of his as-. 
sistants, by the instruments, the objects used for dressings, the. 
1 Terrillon and Chaput—A sepsie and antisepsie chirurgicales, p. 4. 
4 
