284 STERILIZATION, ANTISEPSIS AND DISINFECTION 
for example, indol) react with hypochlorous acid to form the group 
= NC1, which is strongly antiseptic. Thus: 
\- 
\/ NH \/ N.Cl 
Inasmuch as proteins are compounds of amino-acids, some of which 
contain the group =XH, a protein-hypochlorous acid combination 
under certain conditions becomes strongly antiseptic, without being 
very toxic to the host. 
In practice, the substance known in Europe as chloramine-T and in 
America as chloragene, or para-toluene-sodium-sulpho-chloramide, 
(C6H5.SO2XaXCl.3H2O), prepared by Dakin, is extensively used for 
the treatment of wounds. It is quite soluble in water and as a 2 per 
cent aqueous solution is practically non-toxic and very antiseptic. 
In addition it possesses very considerable powers of penetration. 
Inasmuch as the effective element, chlorine, is rather rapidly oxidized, 
it is necessary to renew the solution at relatively frequent intervals. 
Dichloramine-T, a substance somew^hat similar to chloramine-T but 
containing two replaceable chlorine atoms, is practically insoluble in 
water but it may be used in solution in chlorinated paraffin of low 
melting-point. Usually a 5 to 10 per cent preparation in paraffin is 
used. This is sprayed upon the infected part, after being gently 
warmed to the point of fluidification. 
Instruments.— The preparation of instruments for surgical use, 
often erroneously called "sterilization," must be sharply distinguished 
from true sterilization in the bacteriological sense. Simple boiling of 
surgical appliances in soda solution does not necessarily render them 
free from bacterial spores, although the method is efficient for surgical 
technique because the residual bacteria which may survive this treat- 
ment do not germinate in the tissues. It is frequently deemed suffi- 
cient to boil syringes and other appliances used for removing blood or 
other material for bacteriological study in water; the results are usually 
disappointing and blame often attaches to the bacteriologist. The only 
trustworthy method of sterilizing apparatus for blood cultures is the 
autoclave or the hot-air sterilizer, depending upon the nature of the 
appliance. 
The use of carbolic acid is not recommended for bacteriological 
syringes and other apparatus used in collecting material for bacterio- 
logical examination; it is difficult to remove the last traces of the 
disinfectant without contaminating the instrument itself. 
Clinical Thermometers, Dental Instruments.— Clinical thermo- 
meters and dental instruments are ethically on a par with the common 
drinking cup and the common towel. Barbers' razors and brushes^ 
> Anthrax spores have been found in shaving brushes, and the disease has been intro- 
duced into numerous individuals through minute razor cuts. A new shaving brush 
should be regarded as a potential source of danger unless some guarantee of its freedom 
from anthrax spores can be afforded. 
