The times. [volume] (Washington [D.C.]) 1897-1901, 1901-02-03

boiled, and. secondly dressings are either
STEPPED in such solutions as have been
found to destroy the bacteria, such
as carbolic acid or corrosive subj
mate, or other preparations, or still
better are placed In steriiizers, that
Is to say. metal cylinders. which
are then filed with steam, usually
under pressure as to obtain tempera-
tire of 80 degrees. and thus make sure
of the death of the bacteria Unfortu-
nately our hands cannot be boiled or
steamed. but the modern surgeon first
uses soap and water most vigorously over
his hands and arms up to the elbow The
nails are cut short and the scrubbing
brush is especially applied to the nails
so as to clean the fingers at their ends.
Then by various means. such as pure al
cohol. which Is one of our best disinfec-
tants. or solutions of corrosive sublimate.
and other means too technical to mention,
the hands are sterilized. Rubber gloves
are frequently used so as to preclude in
fection, as they can be stezmed to 80
degrees. Removing at least his outer
clothing. the surgeon puts on cotton
gown which has been steamed and so
made free from bacteria. Not a few sur
geons also wear sterilized caps. so that
any bacteria in the hair will not be Site
into wound. and some wear respIratc
of sterile gauze over the mouth and be
for the same reason. All the dress
have been sterilized by superheated ste
All the threads by which blood vessen
are tied have been either boiled or other
wise sterilized. All the material for sew
ing up the wounds and the needles with
which they are sewn up have been sini-
larry disinfected. The skin of the patient
Is also steriiized, usually the day before
hand, In the same manner in which the
surgeons hands have been disInfected and
are disinfected second time just at the
moment Of the operation. II the case
is one of accident such as a crushed leg
from trolley car. all of the dirt is most
carefully washed away with soap and
water and the parts are disinfected. not
only on the exterior. but also by prolong-
ed washing with some cleansing agent i'm
the interior Of the wound. the patient be-
ing under the influence of ether. of
course
1t is easily seen from such description
of modern operation that no case can
receive due care In one of our modern
homes, even the best. The facilities do
not exist and hence surgeons are more
and more declining to do operations
whether for accident or disease in private
houses. and a happy custom is growing
more and more in favor with the commu-
nifty OF having all operations done and all
accidents cared for In a well-equipped
modern hospital
XI.-RESULTS OF MODERN SURGERY.
As the result of our ability to perform
operations without pain, thanks to anaes-
thesia. and our ability to perform opera
tons without infection and, therefore. a.
most without danger, thanks to antisepsis
the range Of modern surgery has been
enormously increased. Unless one has
lived through the old surgery and into
the new he scarcely can appreciate this
widening of the field of operative sur
gerry Thirty years ago. in consequence
of the great danger Of opening the head.
the chest, or the abdomen, or in fact of
making an incision anywhere about the
body. the surgeon never dared to inter-
fere until he was obliged to do so. Hence.
not only were many modern operations
not even thought of, but in obscure cases
we had to wait until time and disease
developed symptoms and physical signs
such that we were sure of our diagnosis
and then. knowing that death would fol-
low If we did not interfere we ventured
to operate. Now, we anticipate such a IA
tai termination and in most cases can
avert il. In perhaps no class of cases
has the benefit of this immunity from
Inf md dapUar haar hatfar chou,
than in the obscure diseases of the brain
and the abdomen. Today if we are uncer-
tain as to whether there is serious danger
going on which If unchecked will result
in death we deliberately open the one
cavity or the other in order to find out
the exact state of affairs. Surprising that
the mischief is trifiing. or even that there
is no mischief. We then know how to
deal with the symptoms which have been
puzzling us. So far as the exploratory
operation is concerned. the patient re-
covers from Ii In a short time, and mean
time perhaps has also been cured of the
symptoms which were before so i'll under
stood. If any serious disease is found,
in the majority of cases we can cope with
1t successfully. Before the days of anti
sepsis and anaesthesia the field of opera
ton was greatly restricted and practically
the removal of tumors. amputations. and
a few other operations were all that were
done. Now, all the then inaccessible or
gans are attacked with an intrepidity born
of an assurance of safety. Recovery usu-
ally sets the seal of approval on the judg-
ment of the surgeon. Thirty years ago,
taking all operations together. fully one
third of our patients died. many of them
often from slight operations which were
followed by Infection Today, including
even the far more grave operations which
are nov done. the general mortality will
exceed per cent. and many sur
geons are able in series of several hun
bred operations to save ninety-seven out
of every hundred patients.
XIII.-SERUM TREATMENT.
Another remarkable recent discovery.
the result of numerous and careful inves-
legations in the laboratory, is a wholly
new means of treatment: viz. that method
which is known as orrhotherapy or serum
sherapy, or the treatment by injecting
certain sntitoxins under the skin by
hypodermatic syringe. 1t would lead me
too far to enter into the theory upon
which these were first used. Suffice it
to say that in the blood of an animal that
has passed through a certain disorder the
liquid part contains an antidote or anti
toxin. II a certain amount of this is
injected under the skin of an animal or
man suffering from the same disorder in
its incipient stages. the antitoxip prevents
the development of the disease. The use
OF this method has thus far been much