488 
Antiseptics  and  the  War. 
f  Am.  Jour.  Pharm. 
^   November,  191 7. 
deadly,  modern  missiles.  As  the  war  progressed,  experience,  to- 
gether with  painstaking  care,  began  to  mold  and  develop  systematic 
methods,  which  appear  to  give  certain  and  satisfactory  results. 
It  is  my  intent  to  present  in  this  paper  the  important  facts  con- 
cerning the  various  chemicals  and  substances,  that  are  to-day  playing 
a  big  role  as  antiseptics  in  this  war.  It  would  be  almost  impossible 
to  detail  the  approved  methods  of  treatment  by  these  substances,  as 
the  extended  experience  and  knowledge,  from  the  masses  of  cases 
treated,  have  evolved  a  system  in  which  the  wounds  are  differen- 
tiated and  subdivided  into  groups.  These  in  turn  are  placed  in 
special  wards  and  treated  by  men  who  are  especially  qualified  to 
handle  the  particular  class  of  wounds  only. 
The  search  for  the  ideal  germicide  began  when  Pasteur's  ideas 
were  put  into  practice  by  Lister  and  his  collaborators.  The  latter 
applied  the  first  principles  in  the  prevention  of  infection.  They  can- 
not, however,  be  credited  with  the  solving  of  the  bigger  problems 
that  this  war  has  brought  forth,  the  mastering  and  conquering  of 
infections  that  have  already  progressed  to  an  alarming  extent. 
In  surgery  of  the  days  preceding  this  war,  the  greater  number 
of  wounds  were  indeed  simple,  not  infected,  and  primarily  clean. 
The  technique  in  treatment  depended  upon  the  use  of  soap,  water, 
alcohol,  phenol  or  cresol  solutions,  iodine,  sterile  dressings,  and  the 
upkeep  of  the  patients'  bacterial  resistance.  But  the  demands  now 
made  upon  surgery  by  modern  warfare  necessitated  a  search  for 
agents  to  treat  infection,  as  the  vast  majority  of  the  wounds  in  this 
war  are  grossly  infected  before  coming  into  the  hospital. 
The  newer  antiseptics  may  be  roughly  divided  into  two  classes : 
( 1 )  those  that  depend  upon  chlorine  for  their  bactericidal  properties, 
(2)  those  included  in  the  class  of  dye  products,  all  of  which  are 
elaborate  chemical  compounds. 
The  Hypochlorites. — The  bleaching  and  bactericidal  properties 
of  the  hypochlorites  may  be  traced  back  to  1788,  when  Berthollet 
obtained  a  disinfectant  liquid  by  treating  alkali  with  chlorine.  In 
1846,  Semmelweiss  aborted  an  epidemic  of  puerperal  fever  by  the 
use  of  hypochlorite  of  calcium.  From  time  to  time,  various  investi- 
gators reported  the  active  antiseptic  properties  of  the  different 
hypochlorite  solutions.  It  has  been  found,  however,  that  the  latter 
are  unstable  and  too  caustic  for  medicinal  as  well  as  surgical  use. 
It  then  remained  for  Dakin,  Carrel  and  their  associates  to  correct 
these  reprehensible  qualities  and  adopt  them  to  the  big  role  they 
are  playing  to-day. 
