AUTO-INFECTION IN CHILDBED.
Ahlfeld (Cent. f. Gyn., No. 52,) shows that it is not always safe to presume upon the impossibility of self-infection, and reports two cases in point. In rare cases infection may arise from organisms primarily present in the genitalia. [This goes to fortify Auvard’s position.]
OCCURRENCE OF GERMS IN THE DISCHARGES FROM THE UTERUS AND VAGINA DURING THE PUERPERAL PERIOD.
Döderlein (Arch. f. Gyn., B. xxxi., H. 3,) finds in a series of carefully conducted observations, that in normal cases the uterine discharges contain no germs, while in the same patients numerous varieties of germ life abound in the vagina. Pathogenic organisms may occur in the vagina apart from any internal examination. These germs may gain access to the uterus of themselves when not carried by intra-uterine instrumentation or manipulation. These conclusions are confirmed by Kaltenbach.
The uterine lochia of women suffering from puerperal sepsis in any form invariably contain germs, the streptococcus pyogenes being constantly present.
SUBLIMATE SOLUTION.
Laplace has shown the importance of acidulating sublimate solutions for general antiseptic use. Neutral solutions on mingling with blood or other albuminous fluids become more or less inert by the precipitation of the albuminate of mercury. That precipitate is not formed in the presence of hydrochloric or tartaric acids. The proportion for sterilizing wounds should be five parts of the acid to one of the sublimate in one thousand of water. [Biniodide solutions require no acid. This is one of the many advantages of the mercuric iodide over the bichloride for antiseptic use. In a series of experiments made for the purpose of determining the reaction of biniodide solutions on albuminous fluids we found that neutral solutions of the biniodide of mercury yield no precipitate with albuminous fluids. No reaction was obtained with a biniodide solution acidulated with hydrochloric acid in the proportion of five parts to the thousand. The addition of organic acids, such as acetic, citric or tartaric, as is well known, causes a precipitate of albuminate of mercury. There is no chemical incompatibility between sublimate soap and biniodide solutions.]
TRICHLORIDE OF IODINE.
One of the new antiseptic agents is iodine trichloride. In contact with organic bodies it gives off iodine and chlorine in the nascent state. The final products, moreover, hydrochloric and iodic acids, are well known oxidizing agents. The strength of solution used is one part in 1,000 or one in 500 parts of water. Such a solution is equivalent in sterilizing power to a 1:1,000 or 2,000 sublimate solution. [One disadvantage of this antiseptic is the powerful corrosive action of nascent chlorine and iodine upon metal instruments.]