DISINFECTANTS. ANTISEPTICS 171 



In recent times the use of antiseptics has been limited in human 

 surgery and for a time they were even given up entirely. Schim- 

 melbusch and others contended that the development of germs in a 

 wound could not be prevented with certainty by disinfectants 

 even when they were applied as early as one minute after the 

 infection; disinfection was therefore not only ineffective, but also 

 harmful, because it irritated the tissues and increased the wound 

 secretions. In place of the antiseptic wound treatment, the aseptic 

 method was proposed. Antiseptic fluids are not employed in the 

 latter method, but the wound is kept as dry as possible by means of 

 sterilized tampons, or is irrigated only with sterile water or sterile 

 physiological salt solution, and then covered with sterilized dress- 

 ing material. The latter is sterilized in a special apparatus by 

 prolonged (20 to 30 minutes) exposure to live steam of at least 

 100° C. In a similar manner, the instruments are made germ-free. 

 They are most certainly sterilized, however, by prolonged boiling 

 in a 1 to 2 per cent, soda solution. Especial care is given to the 

 disinfection of the operator's hands. After the nails are thor- 

 oughly cleaned, the hands are carefully brushed with soap and 

 warm water, then washed with warm sublimate, carbolic acid or 

 creolin solution and finally rinsed with 50 per cent, alcohol or soap 

 spirit. Care is also taken to keep aseptic the entire operating 

 room, the operation table, the clothing of the patient, operators, 

 assistants and attendants, all of the utensils used and the area 

 surrounding the wound (field of operation). Mull masks for the 

 mouth and nose of the operator are even used. 



The aseptic treatment of wounds was regarded as an important 

 advance in human surgery because it left the healing of the wound 

 to the natural protective forces of the tissues (leucocytes, blood- 

 serum) and only guarded against external disturbances. More 

 recently, after Henle and others had shown that, contrary to 

 Schimmelbusch, local disinfection of wounds within the first hours 

 is very effective, and after it had been proven by statistics that the 

 results of the aseptic method were in no way more favorable than 

 the antiseptic, numerous surgeons changed from the purely aseptic 

 method to antisepsis (disinfection of the skin with tincture of 



