49° 
Antiseptics  and  the  War. 
f  Am.  Jour.  Pharm. 
November,  1917. 
lamentable  results  when  solutions  containing  boric  acid  have  been 
used,  and  such  action  is  claimed  to  be  due  to  the  sodium  borate 
formed.  The  Dufrasne  solution  has  also  been  found  to  be  more 
bactericidal  and  less  caustic  than  the  original  formula. 
In  preparing  the  solution,  the  two  important  facts  essential  to 
note  are  that  the  end  product  is  to  be  absolutely  free  of  alkali  and 
the  solution  should  not  be  used  if  the  hypochlorite  content  is  much 
below  .45  per  cent,  or  above  .5  per  cent,  (which  corresponds  to 
about  .22  per  cent,  available  chlorine).  This  particular  strength  can 
be  maintained  with  little  variation  for  at  least  a  month,  a  fact  which 
in  itself  ought  to  discourage  the  use  of  modified  formulas  for  extem- 
poraneous preparation.  I  have  kept  a  solution,  that  originally  con- 
tained .487  per  cent,  sodium  hypochlorite,  for  over  34  days  before 
its  strength  registered  below  .45  per  cent.  The  latter  solution  was 
kept  in  4-ounce,  8-ounce,  i-pint  and  -gallon  amber-colored  bot- 
tles, both  in  the  light  and  in  a  dark  place,  and  the  identical  solution 
kept  in  green  glass  bottles,  and  placed  in  the  dark,  showed  almost 
similar  results. 
Besides  the  two  important  facts  noted,  success  or  failure  in 
treatment  depends  on  the  mode  of  procedure.  It  can  be  safely  said 
that  those  who  reported  valueless  results,  when  using  this  solution, 
employed  a  preparation  that  was  faulty  or  they  knew  too  little  of 
how  to  put  it  to  service  in  treating  wounds ;  and  it  is  due  to  its 
improper  use  by  such  individuals,  that  the  idea  was  at  times  con- 
veyed that  Dakin's  solution  is  a  useless  panacea.  It  is  not  a  "  cure 
for  all "  but  very  valuable  in  many  cases,  when  each  and  every  step 
is  exactly  and  implicitly  followed  out,  as  directed  by  Dr.  Carrel. 
In  the  first  place,  all  areas  surrounding  the  wound  should  be 
cleaned  with  ether  or  benzene.  After  shaving  the  area  encircling 
the  wound,  all  dead  tissue  should  be  cut  away.  Be  certain  that  all 
of  the  necrotic  and  devitalized  tissue  as  well  as  all  foreign  matters 
are  removed.  After  further  cleansing  with  soap,  the  area  is  painted 
with  iodine.  Then  with  fresh  sterile  instruments,  the  wound  is 
opened  and  exposed,  preferably  in  basin-like  cavities.  All  bleeding 
parts  are  carefully  and  cautiously  controlled.  Special  care  is  to  be 
noted  that  all  blood  clots  are  removed,  as  the  hypochlorite  solution 
dissolves  blood  clots,  and  subsequently  severe  secondary  hemor- 
rhage may  set  in.  The  final  treatment  before  applying  the  solution 
is  to  place  bandages,  enmeshed  with  petrolatum  along  the  edge  of 
the  wound  so  as  to  avoid  irritation  of  the  surrounding  skin  tissue. 
