Wounds of Men ivho received Prophylactic Inocidation. 539 



Addendum. 



An Inquiry into Surgical Procedures in Relation to Degree and Persistence of 

 Anaerobic Infections of Wonnds. 



This inquiry, which was carried out by Miss Cayley, indicated that — 



(a) No one of the antiseptics under investigation could be recommended as 

 being of special value in the elimination of anaerobic infection. 



(6) Anaerobic bacilli, even those of pathogenic significance, may persist in 

 wounds until the completion of the process of repair. 



(c) The degree of anaerobic infection of wounds that have been excised is, 

 on the whole, less than in those that have not been so treated. Excision, 

 then, while it does not eliminate infection, does so alter the condition of the 

 wound that the harmful capacity of any anaerobes present is much reduced. 



{d) In examining in vitro the influence of Brilliant Green and other 

 aniline dyes on the growth of anaerobes, it was found that their activity was 

 much reduced when cultures were made in Tarozzi tubes (4). This reduction 

 of activity was more marked than that caused by the presence of serum. 

 This observation has a direct bearing on the application of aniline antiseptics 

 in surgical therapeutics. 



Technique. 



In making the investigation summarised in Section I, the following 

 technique was elaborated : — 



The swabs were taken from the deeper parts of the wounds as far as 

 possible ; then emulsified in 3 cub. centim. of sterile saline. Of this, 

 I cub. centim. was inoculated into ordinary meat-water medium — Culture A. 

 This culture gave an index of the non-sporing organisms present. 



The remainder — 2 cub. centim. — was heated to 80° C. for 10-15 minutes, 

 or to 60° for 30-40 minutes. Of this, 1 cub. centim. was inoculated into 

 a tube of meat-water medium and incubate jl anaerobically — Culture B. This 

 gave an index of the sporing anaerobes present. The 1 cub. centim. which 

 remained was inoculated into a tube of " selective " medium — designed to 

 give an overwhelming growth of end-sporing bacilli — Culture C. 



The " selective " enriching medium was prepared as follows : — 



Take 1 lb. of chopped raw meat, add 1 litre of tap-water, and boil for 

 30 minutes in a water-bath. Cool to 45° C, make slightly alkaline to 

 litmus, and add trypsin as for the preparation of Douglas' broth. Then 

 incubate in an open vessel for four to five days at 37° C, allowing the 

 material to undergo natural putrefaction. Filter the putrescent material so 

 obtained through filter paper ; neutralise to phenolphthalein at room-tem- 

 perature. Prepare a conical sterile filter flask containing a layer of liquid 



