The foregoing brief statements exhaust most of the possibilities of wound infection by means of micro-organisms. There is however another source of infection, not yet definitely proved to be of microbic origin, which has important relations to circumcision. This is the poison of Syphilis. If the Mohel should be suffering from this disease the secretions of the mouth are infective and the disease may easily be transmitted to the infant by means of Metzizah. On the other hand, should the infant be born with the disease—a circumstance of not infrequent occurrence—it must be remembered that its blood is charged with the poison, and is capable of infecting a healthy individual when it is brought into contact with any wound, abrasion or other breach of surface.
CHAPTER III.
Elements of the Antiseptic Method.
The purpose of Antiseptic Surgery is to avoid the occurrence of the dangers of infection referred to in the preceding chapter. There are many methods of carrying out the system, but the present description being limited to the requirements of circumcision does not aim at being exhaustive. The two objects aimed at are:
1) The prevention of any micro-organisms gaining entrance to the wound. This end is attained by the disinfection of the hands and especially the thumbnails of the operator, of the instruments and dressings used; and by perfect cleanliness of the genitals of the infant. It may be said that the brief exposure of the parts during the performance of the circumcision carries with it no risk of infection, because the organisms we have been considering are not usually airborne.
2) The application of such dressings as will keep the wound in an aseptic condition. Even the small amount of discharge from a circumcision wound forms a splendid soil for the growth of micro-organisms. It is necessary therefore to apply a dressing which has been saturated with such antiseptics as will destroy that constituent of the discharge which makes it a good culture material.
The most convenient antiseptic for general use is Carbolic Acid. This is a clear, colourless liquid of rather oily consistence, which rapidly becomes converted into solid crystals in cold weather. When required for purposes of disinfection it should be mixed with 39 times its quantity of water, or roughly one pint of water requires one tablespoonful of pure Carbolic Acid to make a solution of 1 in 40.