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Updated: May 10, 2025
"Hi, Brandon," the surgeon grunted as he straightened up, the work completed. "I did not use much antiseptic on him. Because of possible differences in blood chemistry and in ignorance of his native bacteria, I depended almost wholly upon asepsis and his natural resistance. It is a good thing that we did not have to use an anaesthetic.
The use of antiseptics has been decried in the interest of asepticism, as if the whole purpose of antisepticism were not to secure asepsis.
These procedures may be carried out at the same time as the sequestrum is removed, or after an interval. In all of them, asepsis is essential for success. The deformities resulting from osteomyelitis are more marked the earlier in life the disease occurs.
Nearly the same story as with regard to anæsthetics has to be repeated for what are deemed so surely modern developments, asepsis and antisepsis. I have already suggested that Roger seems to have known how extremely important it was to approach operations upon the skull with the most absolute cleanliness.
By the various statements and claims made in this chapter, I do not wish to convey the idea that I am opposed to scrupulous cleanliness or surgical asepsis. Far from it! These are dictates of common sense. But I do affirm that the danger from germ and other infectious diseases lies just as much or more so in internal filth as in external uncleanliness.
Drainage of wound secretions, which usually become infected, is necessary, because with obstructed drainage in an infected wound of this kind, there will result an early destruction of tissue at some point sutured. Daily irrigation done in a manner that practical asepsis is carried out, is necessary for about a week.
But a puncture made in a similar manner and with the same instrument without due regard to asepsis is likely to cause an infectious synovitis and arthritis usually follows.
Cleanliness and asepsis must go hand in hand with the purification of the inner man in order to insure natural immunity. The Laws of Cure This brings us to the consideration of acute inflammatory and feverish diseases. From what has been said, it follows that inflammation and fever are not primary, but secondary, manifestations of disease.
In the light of what we now know about the necessity for absolute cleanliness, asepsis as we have come to call it, it is rather startling to note the directions that are given to a surgeon to be observed on the day when he is to do a trepanation.
Initial freedom from bacteria is the ideal of asepsis; to secure it, the modern surgeon is ever watchful of the cleanliness of his hands, his instruments, his dressings, and of the site of operation or whatever may come near it.
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