The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Another measure of great utility in selected cases is the intravenous
infusion of a solution of Credé’s soluble silver, made with 1 gram
of silver in 1000 Cc. of sterilized water at a temperature of 105°
to 110°. In cases of profound toxemia a small amount of blood may
be withdrawn (50 to 400 Cc.), for reasons stated in Chapter VI. No
hesitation need be felt in introducing 500 Cc. or even 1000 Cc. of
this solution. It is the ideal way of bringing a powerful non-toxic
antiseptic into immediate contact with pathogenic microbes.
There have been recent suggestions as to the intravenous injection
of very dilute _formalin solution_, in order to take advantage of
its remarkable germicidal activity; it has been employed in a few
cases, especially of puerperal sepsis, with success, 1 Cc. of standard
formalin solution is mixed with 800 Cc. of sterilized salt solution. It
has been shown that if 50 Cc. of this is thrown into the veins of an
average adult it will form with the 5000 Cc. of blood a mixture of 1
to 200,000, in which strength it may be expected to prove an efficient
bactericidal agent. Indeed, a smaller amount or a weaker preparation
would probably suffice. Barrows has reported success following two
infusions, two days apart, of first 500 Cc., then 750 Cc. of a 1 to
5000 formalin solution. Still, these injections may be followed by
cramps in the arms, cardiac discomfort or distress, and blood (or blood
cells) in the urine. It would probably be well to limit this use of
formalin to those cases at least in which the presence of cocci in the
blood can be demonstrated by culture or other method.
An excellent method in the local treatment of parts which admit of it
(hands and feet) is their exposure to dry hot air in the Kelly heater
or some similar apparatus. Hot air will be borne at a temperature of
210° to 220°, which may be destructive to germs while still tolerable
for a short time by the tissues. Clinton, of Buffalo, with whom this
method is original, reports that the temperature within the tissues
thus treated is raised to about 107°, which is above the thermal death
point of the ordinary pyogenic organisms, and that this method gives
better results than any other of treatment of septic infection of those
parts which can be subjected to it.
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