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Wright, who has little, if any, faith in anti- septics, pro|)Oscs to rcen force the organic defence by hypertonic solutions at twenty per i.ooo which in- hibit bacterial growth and solutions at fifty to 1,000 which completely overcome it. Briefly, \Vright ad- vises treating wounds at the dressing station by hemostasis, cleansing, the application of dressings, Cialis 20 Mg Costo Farmacia immobilization, and injection of vaccines; at the am- bulance by removal of foreign bodies, free incision and irrigation with a 50 :i .000 salt solution, and pack- ing the wound with salt tablets. From all I can learn, the English surgeons are not overjoyed witli results obtained and a reaction has taken place un- favorable to the salt treatment. It has never had much of any vogue among our French confreres. Pure sea water has been proposed by some in France but has not, I believe, been favorably met with. On the other hand various physiological comjxjund sera Cialis 20 Mg Costo Farmacia have been essayed nnd I give several fonnulx. The composition of the Hcdon-Flcisj is as follows: 940 MEDICINE AND SURGERY IN THE ARMY AND NAVY. [New York Medical Jouknal. Sodium Cialis 20 Mg Costo Farmacia chloride, 6 grams ; Potassium chloride 30 centigrams ; Calcium chloride 10 centigrams ; Magnesium chloride 30 centigrams ; Sodium phospliate, 50 centigrams ; Sodium bicarb 1.50 gram ; Glucose I gram ; Cialis 20 Mg Costo Farmacia Water 1,000 grams. Sonbeyran advises Schiassi's fluid: Sodium chloride 6.50 grams ; Potassium chloride 30 centigrams ; Melted calcium chloride, I gram ; Sodium bicarbonate, 50 centigrams ; Glucose, 1-50 gram; Water i,0oo grams. The solution is sterilized without the calcium chloride, which, when hot, gives calcium carbonate ; the -Slock solution of calcmm chloride at ten Cialis 20 Mg Costo Farmacia per cent, is sterilized by itself and a sulikient quantity is added to the solution. Grautrelet and others are warm in their praises of the Ringer-Locke solution, but, as this must now be known to all, I omit it. The above solutions ars isotonic and do not in- terfere with osmosis or hemolysis. Now, Delbet has carried out researches — I do not say that they are convincing — on the action of these and other solutions on phagocytosis. He has found, on an average, that leucocytes immersed in Le- clainche's serum phagocyte showed 109 bacteria. For some month past there has certainly been much adverse comment made as to the real value of antiseptics in war surgery. It is upheld by some that antiseptics should possess a germicidal action such that, even when their activity is reduced in con- tact with the serum and other protein bodies, they should still retain a powerful antiseptic action Sol- uble salts whicii are not precipitated by protein bodies penetrate tlie tissues and are absorbed by them are unquestionably Cialis 20 Mg Costo Farmacia more potent than those whose penetrating power is less. An ideal antiseptic is that possessing a low toxicity and a mild local ir- ritating action with a high bactericidal action, so that large quantities of the substance can be employed. An antiseptic must not inhibit phagocytosis, should kill bacteria but not the living cell. Briefly, it should be cytophylactic. And lastly, an antiseptic must not be h}q>otonic to the medium in which the cells live ; therefore, it must not interfere with osmosis. The opponents of antiseptic treatment maintain that there is no antiseptic fulfilling these conditions. Disturbances which they occasionally produce have been laid at their door, such as gangrene (carbolic acid), simple or Cialis 20 Mg Costo Farmacia febrile erythemata, acute or chonic poisoning, dematitndes, and divers toxic phenomena (sublimate), eczema (iodoform), headache and other symptoms (iodine), and a Cialis 20 Mg Costo Farmacia host of others too long to enumerate. These are facts known for years and do not deserve mention. But, unfortu- nate results arising from the indiscriminate use of active substances or from individual idiosyncrasy, are not sufficient reasons for giving up valuable and well tried measures for controlling septic processes. Antiseptics have been accused of causing tissue changes when they impregnate them. Tincture of io- dine (ten per cent.) or powdered calcium liy])0- chlorite are said to produce secondary hemorrhage by ulceration of the bloodvessels, as if infection was not in itself quite enough to give rise to pathologic changes in the vessel walls! The opponents of anti- sepsis seem to lose sight of the fact that by destroy- ing the tissues in an infected area, as is done, for example, in gas gangrene with the thermocautery, a barrier to the infection is set up and certainly one of our most effective means of sterilizing serious foci of infection is by carbonization with heated air. Antiseptics not infrequently owe their curative effects to their irritating action on the tissues and certain surgeons thus explain the results obtained with solutions of the hypochlorites and then seize