438 
Antiseptics. 
f  Am.  Jour.  Pharm. 
*•       June,  1 918. 
as  its  osmotic  pressure  is  equal  to  the  pressure  of  the  plasma  of  the 
body).  Such  procedure,  though  successful  with  a  limited  number 
of  patients,  obviously  cannot  be  applied  in  a  casualty  dressing  sta- 
tion; the  wounds  are  always  contaminated:  they  are  deep,  often 
ramifying,  and  may  contain  pieces  of  clothing  or  splinters,  all  pre- 
sumably carrying  infection.  To  meet  such  conditions  powerful 
remedies  are  necessary,  but  they  must  be  discriminatingly  powerful ; 
microbes  which  are  vegetable  cells  must  be  killed,  both  vegetative 
forms  and  spores,  which  are  much  more  resistant.  At  the  same 
time  the  animal  cells  of  the  tissues  must  be  damaged  as  little  as  pos- 
sible by  the  antiseptic ;  free  drainage  for  all  discharges  from  the 
wound  must  also  be  maintained. 
In  opposition  to  the  antiseptic  method  there  is  what  has  been 
called  the  physiological  method  of  wound  treatment,  introduced  by 
Sir  Almroth  Wright.  The  wound  is  treated  with  a  hypertonic 
saline  solution,  i.  e.,  a  solution  having  an  osmotic  pressure  higher 
than  that  of  the  plasma.  As  a  result  of  this,  fluid  is  rapidly  poured 
out  by  the  tissues,  the  idea  being  that  the  microbes  are  thus  washed 
out  of  the  wound  and  at  the  same  time  destroyed  by  the  bactericidal 
properties  of  the  lymph. 
In  support  of  this  method  the  argument  was  advanced  that  any 
antiseptic  damages  the  tissue  to  which  it  is  applied  to  such  an  extent 
that  the  value  of  it  as  a  destroyer  of  bacteria  is  lost,  and  the  dead 
cells  and  coagulated  albumin  which  the  antiseptic  leaves  in  the 
wound  are  a  fertile  source  of  further  trouble.  By  hypertonic 
saline  treatment  this  difficulty  is  avoided.  With  these  two  prin- 
ciples in  mind,  our  object  was  to  find  an  antiseptic  agent  thor- 
oughly efficient  as  a  killer  of  bacteria  and  spores,  and  at  the  same 
time  harmless  from  the  point  of  view  of  the  wound  tissues. 
Our  first  step  was  to  test  the  comparative  efficiency  of  all  the 
antiseptics  in  general  use.  It  is  obvious  that  it  is  impossible  to 
make  a  definite  statement  as  to  the  value  of  an  antiseptic  for 
wound  treatment  from  its  behavior  under  laboratory  conditions. 
Most  elaborate  experimental  methods  have  been  devised  in  the  en- 
deavour to  fix  a  standard  by  which  antiseptics  may  be  tested,  but 
further  research  has  shown  that  so  many  factors  enter  into  the 
efficiency  problem  that  test-tube  methods  have  come  to  be  regarded 
more  or  less  as  a  compromise.  For  instance  Chick  and  Martin3 
have  shown  that  what  might  be  called  mass  action,  i.  e.,  the  actual 
3  Chick  and  Martin,  Journal  of  Hygiene,  1908,  8,  654. 
