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Updated: April 30, 2025
It is not unlikely, therefore, that they had also arrived at the recognition by observations on many patients that the satisfactory after-course of these cases which were operated on by the surgeon after due regard to such meticulous cleanliness as is suggested in the paragraph I have quoted, made it very clear that these aseptic precautions, as we would call them, were extremely important for the outcome of the case and, therefore, were well worth the surgeon's attention, though they must have required very careful precautions and considerable self-denial.
Some hung eagerly around the airlocks of ships on the grid tarmac, waiting their turns to stand in corrosive gases for the decontamination of their suits, when they would burn the outer layers and step, aseptic and happy, into a Wealdian ship again. There they could think how rich they were going to be back on Weald. But the situation aloft was bewildering and very, very ominous.
Sometimes the thrombus is mixed a red thrombus being deposited on a white one, it may be in alternate layers. When aseptic, a thrombus may become detached and be carried off in the blood-stream as an embolus; it may become organised; or it may degenerate and undergo calcification.
All clots must be removed and the drug applied directly to the bleeding surface. Adrenalin and turpentine are the most useful drugs for this purpose. Hæmorrhage from bone, for example the skull, may be arrested by means of Horsley's aseptic plastic wax.
The importance of the changes wrought by the adoption of aseptic methods requires no emphasis, for the marvels of modern surgery are even more impressive to laymen than to the medical profession. Everybody now understands that strict cleanliness is indispensable to the success of a surgical operation.
Lord Lister is entitled to the full credit of establishing the aseptic surgery of the present day, in spite of the facts that his doctrine followed rather than preceded his early improvements, that aseptic procedures have been brought nearer perfection elsewhere than in his own country, and that the whole system rests on foundations laid by Pasteur.
Careful aseptic precautions must be observed in operating on colts, as they are very susceptible to wound infection and peritonitis. The blood-vessels of the testicular cord are larger in the adult animals, and the danger from haemorrhage is greater than in the young. For this reason, it is advisable to use an emasculator in castrating all mature animals. Complications Following Castration.
Popliteal, carotid and other aneurysms, which are not of traumatic origin, are sometimes dealt with on this plan, which is the old "Method of Antyllus" with modern aseptic conditions. Speaking generally, if an aneurysm can be dealt with surgically the sooner that the artery is tied the better. Less heroic measures are too apt to prove painful, dangerous, ineffectual and disappointing.
No difficulty is encountered in recognizing these conditions even where considerable organization of tissue overlying distended thecae occurs. In such cases there may be only slight fluctuation of the enlargement, but if necessary, an aseptic exploratory puncture may be made with a suitable needle or trocar. Treatment.
The risks incident to this class of wounds are: the extreme difficulty, especially when a dense fascia has been perforated, of rendering them aseptic, on account of the uncertainty as to their depth, and of the way in which the surface wound closes on the withdrawal of the instrument; different forms of aneurysm may result from the puncture of a large vessel; perforation of a joint, or of a serous cavity, such as the abdomen, thorax, or skull, materially adds to the danger.
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