AJanuaryflh897m*}  Modem   Surgical  DreSSVlgS.  2$ 
killers ;  others  were  shown  to  be  valueless.  Power  to  absorb  wound 
secretion  and  exclude  infection  was  made  an  essential  requirement 
for  wound-dressing  material. 
Prevention  became  both  the  watchword  and  the  keystone  of  sur- 
gical technique.  What  is  termed  by  Gerster  "  the  conscientious 
practice  of  thorough-going  cleanliness,"  was  found  possible  of  attain- 
ment by  the  use  of  antiseptics—"  angels  of  cleanliness."  Chemical 
sterilization  has  been  combined  with  mechanical  cleansing.  Natural 
agents,  as  well  as  those  instituted  by  the  operator,  have  been  called 
to  the  aid  of  the  surgeon.  In  this  transition,  antisepsis  has  not 
been  abandoned,  but  has  developed  into  its  higher  form — asepsis. 
The  antiseptic  dressing  has  not  been  discarded,  but  has  become 
aseptic.  The  terms  antisepsis — asepsis,  are  not  antagonistic ;  the 
one  is  not  the  antithesis  of  the  other.  "  Asepsis  is  an  exalted 
degree  of  cleanliness." 
It  is  reached  by  the  surgeon  through  the  aid  of  antiseptics.  The 
antiseptic  agents  employed  to  produce  the  condition  of  asepsis  may 
be  physical — heat,  chemical — carbolic  acid,  etc.,  mechanical — wash- 
ing. These  may  be  supplemented  by  measures  which  exclude  all 
bacteria.  The  aim  sought  is  a  condition  of  freedom  of  septic 
material  or  micro-organisms — asepsis. 
The  Fundamental  Law. — In  the  transition  of  surgical  practice, 
which  we  have  noted,  the  great  guiding  principle  first  recognized  by 
Lister  has  been  strengthened,  viz.:  "  that  the  presence  of  certain 
kinds  of  bacteria  is  an  essential  condition  of  wound  infection." 
From  this  has  been  evolved  the  fundamental  law  that  all  materials 
which  are  to  come  in  contact  with  the  wound  must  be  free  from 
pathogenic  organisms.  To  prepare  a  dressing  which  shall  fulfil  the 
requirements  of  this  law  would,  at  first  glance,  seem  to  be  a  simple 
undertaking.  We  find,  however,  that  the  task  is  not  so  easy  of 
accomplishment  when  we  note  that  over  i 50  species  of  bacteria  are 
classed  as  pathogenic  (6  pyogenic) ;  in  addition  to  this  we  have 
nearly  300  species  of  organisms  classed  as  non-pathogenic  for  lack 
of  information  as  to  their  disease -producing  power.1 
1  Buchner  has  shown  that  many  of  the  common  saprophytes  classed  as  non- 
pathogenic, when  injected  under  the  skin,  cause  local  abscess.  I  have  recently 
witnessed  serious  results  follow  an  experimental  inoculation  of  a  clean  wound 
with  mould  spores  supposed  to  be  harmless. 
