The Salt Lake herald. [volume] (Salt Lake City [Utah]) 1870-1909, 1896-11-29
WONDERS OF THE MODERN sUFaGI-
CAL SKILL.
Two Kinds OF Surgical Cases-How
the Instruments of the Surgeon
"A Science Which Has Advanced.
Rapidly.

unQeclQed, the descriptions ana eX
plantations were as numerous as tn
observers. Pasteur, however, in thos
brilliant studies and experiments tina
commenced originally with the yeas
plant, proved that micro organisms
known as bacteria and microbes, Were
the active agents in all specific infiam
nations. From this trifiing beginning
| has been elaborated the work of the
bacteriologist and pathologist of today
The first man, however, 10 practically
| apply the experiments of Pasteur to
! the solution of the problem of modern
surgery was Sir John Lister, an emf
nept EngliShman, still living and enjoy
| ing the satisfaction of his work. His
| object at the outset was to find some
agent which could be brought in con-
tact with air. killing the germs floating
in il, but one that would not have any
deleterious influence upon the wound.
His first experiment was with carbolic
acid, which was followed by corrosive
Sublimate, both of which were used in
turn, simply for their germ-destroying
propenSitieS. His experiments were eX-
haustive, and did much to advance
surgery on the plane of safety.
Previous TO this such a thing as a
wound healing by what is called pri-
mary intention-that is, without in
fiammation and formation of pus, the
attendant pain and fever, frequent
painful dressings, and often death in
graVer operationS-was so infreQuent
as TO be subject TO remark. The sur
geon had continually before his eyes
the dread picture of erysipelas and
hospital gangrene." Although among
the laity he is so often regarded as the
man with nerves of steel, devoid of all
senSibility to any pain he may cause,
unable to appreciate the anguish fol-
lowing in his tread, yet he has studied
the lessons well. The look of horror
and evidence of suffering which the
drawn face and pinched nose so often
indicate are not the least among the
elements he had learned to dread, and
his hand was surely tempered until his
touch, though firm and mastery, be-
came as gentle as a womans.
Today a different state of affairs ex-
lists. AS an outgrowth of the inspired
genius of Pasteur and Lister, pus, in
Illumination and frequently pain, as at
tendant upon his work, have melted
away as the mists before a morning
sun. He now approaches his patient
with the knowledge that all will go
well; that no link in the chain of tech
nique has been broken. Operations of
the most terrible and severe character
are performed with the utmost impu-
nifty, no part of the living body being
a sealed book. The brain and abdomen,
the chest and all other cavities yield
alike to his exploration, over which
was formerly written: Thus far
shalt thou go and no further"
The consideration of modern surgery
must be divided into two heads-anti-
sepsis and asepsis, TO the former be-
longing Sir Joseph Lister and his fol-
lowers. Briefly, antisepsis consisted IN
saturating the air of the operating
room, the hands and clothing of the
operator and the patient with a solu-
ton of carbolic acid. Atomizers were
kept in constant use, spraying the vo-
latiliZed fluid in every direction, the in
struments and dressings being in the
same saturated medium. This was re-
placed in turn with the corrosive subli-
mate solution, which was poured in and
over the wound, about the operator
and was used in much the same way
These, especially the latter, were found
TO be more or less irritating. and
steadily modern surgery progressed to-
ward what is today elaborated and
used so uccessfully-asepss.
The whole study of the triumph of
asepsis may be summed UP thus: Abb
solute absence of any foreign con-
tamination that may by contact or as
ISOLATION set up any inflammatory con-
dltion. This means a service of clean
illness, not as understood ordinarily.
but a chain, in which every link is
constructed and examined separately.
is made perfect in the fullest sense.
Surgeon, patient, room, tables, instru-
mentS and dressings all go through
the same modified course, even the
clothing worn by the operator and his
assistants being especially prepared
Nothing is left undone, nothing taken
by chance, every element that could by
carelessness do a mischief, however
small, being eliminated. Ideal condi-
tons are hard to find, yet the surgeon
of today, by this unfiagging atten-
ton. works with germ-free hands and
instruments on a igerm-free case. Con-
slant Improvement has made this pos
sible, and asepsis, following after anti
SepsiS, has produced the triumphs of
modern surgery,
All apparatus. where possible, is
made in one piece. Instruments are
constructed of highly polished metal,
50 formed that there shall be no draw
backs to the proper cleansing and no
seams or joints where any foreign mat
GER may lodge. Where they are neces-
sariiy of more than one section or part. !
they are no longer fastened together |
by screws. but each part is so fitted !
that it may be entirely removed and !
while detached cleansed separately |
ms is accomplished by q liberal use /
OF soap and warm water with stiff |
bristled brushes. Such instruments as
are said 20 be used in an operation |
are prepared in one of three WAYS
by being exposed TO superheated air. |
dry steam generated in sterilizer or |
by boiling from 20 to 80 minutes. II (
has been demonstrated satisfactorily |
that the application of sufficient heat
viii accomplish. everytifng-an the /
first requisite in aseptic work is a !
proper supply.
10 stai4ch the flow of blood as The |
operation proceeds. sponges are neces- |
sary. These, after being selected With |
care, are placed in a bag and besten I
and shook until all the foreign mo |
onanical matter is removed. when they |
are transferred to hydrochloric acid |
From this they are washed with re- |
peated quantities of boiling water nm
I'll the acid is all rinsed away. Solu-
ton or permangananate of potash is
next used; this in turn being bIeache5
put with oxalic ac.d. Again sponges
are washed, in sterile water. and after
being immersed in a solution of cor
roSive sublirnate for "a hours they ave
preserved for future use in a SOLUTION
Il carboIc acid, protected from any
contact with air.
Dressings. kgatures ard sutures are
subjected to che same general method
n the carrying out OF the scheme. The
,niy material used for congresses and
coverings is those ClO+bc