A letter from Alexis Carrel concerning the preantibiotic treatment of war wounds: The Carrel-Dakin solution.

The morbidity and mortality of soldiers injured during the First World War stemmed in large part from infections of battle wounds. Preventing and treating such infections was a major challenge for the medical corps. Alexis Carrel, a French-American surgeon, advocated irrigating open wounds with a hypochlorite solution (the Carrel-Dakin solution) to prevent the growth of bacteria contaminating them. His method of treatment was complicated and time consuming and was not well followed by surgeons who doubted the necessity of such an exacting protocol. In 1917, Carrel wrote a letter to an American colonel overseeing U.S. medical personnel soliciting his support in training American medical personnel in the proper use of the Carrel-Dakin solution. This letter was the stimulus for recalling here the opposition encountered by both Carrel and Joseph Lister, his predecessor in the aseptic-antiseptic treatment of open wounds, and for noting the conflicting views of contemporary surgeons over surgical sepsis.

Disinfection in the laboratory: theory and practice in disinfection policy in late C19th and early C20th England.

This article examines the relationship between theory and practice in nineteenth century English public health disinfection practice. Disinfection undertaken by local authorities and practised on objects, spaces and people became an increasingly common public health practice in the last quarter of the nineteenth century, and was part of a newly developed public health system of 'stamping out' disease as described by Hardy. Despite disinfection's key role in public health policy, it has thus far not received significant investigation or historiographical attending. This article explores the development of disinfection policy at local level, highlighting that despite commentators assumptions that increasingly exacting standards of disinfection required professional oversight rather than that of the 'amateur' public, there was a significant gap between laboratory based knowledge and evidence derived from practical experience. Laboratory conditions could not replicate those found in day-to-day disinfection, and there were myriad debates about how to create a mutually understandable scientific standard for testing. Despite increasing efforts to bring local disinfection in line with new ideas promulgated by central government and disinfection researchers, the mismatches between the two meant that there was greater divergence. This tension lay at the heart of the changes in disinfection theory and practice in the second half of the nineteenth century, and illustrate the complexities of the impact of germ theory on public health policy.

Essential tips for nurses.

A useful book for teachers of nurses as well as for their pupils was reviewed in the BJN 100 years ago. It was called, 'A Quiz Book of Nursing,' by Miss Amy Elizabeth Pope, with regard to the restraint of patients, it is suggested that the following points should be emphasized by the instructor:

Knowledge of ancient Hindu surgeons on Hirschsprung disease: evidence from Sushruta Samhita of circa 1200-600 BC.

BACKGROUND: Congenital megacolon is eponymously named after Harold Hirschsprung, who accurately described the clinical features in 1886. Recent research revealed that this condition is perhaps well known for centuries before him. AIM: This article is intended to examine if ancient Hindu surgeons knew about congenital megacolon. METHODS AND MATERIALS: Sushruta Samhita is an ancient tome of Ayurvedic surgery compiled by Sushruta (circa 1200-600 bc). Passages of interest were identified by browsing the authentic English translation of the compendium. Accuracy of translation was verified by comparing to the original Sanskrit verses with the help of a Sanskrit scholar. RESULTS: A condition called Baddha Gudodaram, described in the Samhita, closely resembles Hirschsprung disease. There are indications that ancient Indians even deciphered the etiology as defective vayu alias vata (nerves). Although the ailment was considered incurable, a palliative operation has been discussed. Descriptive details of the operation match with that of sigmoid colostomy. CONCLUSION: Evidence from Sushruta Samhita indicates that Hindu surgeons of prehistoric India probably had considerable knowledge about Hirschsprung disease. Further research, corroborating other sources of evidence, is required to confirm this claim.

Antifouling strategies: history and regulation, ecological impacts and mitigation.

Biofouling increases drag on marine vessels resulting in higher fuel consumption and can also facilitate the transport of harmful non-indigenous species (NIS). Antifouling technologies incorporating biocides (e.g., copper and tributyltin) have been developed to prevent settlement of organisms on vessels, but their widespread use has introduced high levels of contamination into the environment and raised concerns about their toxic effects on marine communities. The recent global ban on tributyltin (1 January 2008) and increasing regulation of copper have prompted research and development of non-toxic paints. This review synthesises existing information regarding the ecological impact of biocides in a wide range of organisms and highlights directions for the management of antifouling paints. We focus particularly on representatives of the recent past (copper and tributyltin) and present (copper and 'booster') biocides. We identify knowledge gaps in antifouling research and provide recommendations relating to the regulation and phasing-out of copper.

[Disinfection in Milan at the beginning of XXth century]. / Il lavoro della disinfezione nella Milano di primo novecento.

The authors analyse some technical and professional aspects of disinfection in Milan at the beginning of XXth century, and the work of Vittorio Maragnoli. Also the use of HCN vapours in disinfestation is here analysed.

[Brief history of the syringe]. / Une brève histoire de la seringue.

Since the Greek Antiquity, the syringe was used to introduce some liquids through natural orifices; the invention of the hollow needle by Pravaz allowed the injection to be used through the skin or the blood vessels. Between 1841 and 1853, with the aid of the cutler Charrière, he succeeded in manufacturing a prototype of his syringe which is displayed in the museum of Lyons.

The history of ultraviolet germicidal irradiation for air disinfection.

Public health concerns such as multi- and extensive drug-resistant tuberculosis, bioterrorism, pandemic influenza, and severe acute respiratory syndrome have intensified efforts to prevent transmission of infections that are completely or partially airborne using environmental controls. One such control, ultraviolet germicidal irradiation (UVGI), has received renewed interest after decades of underutilization and neglect. With renewed interest, however, come renewed questions, especially regarding efficacy and safety. There is a long history of investigations concluding that, if used properly, UVGI can be safe and highly effective in disinfecting the air, thereby preventing transmission of a variety of airborne infections. Despite this long history, many infection control professionals are not familiar with the history of UVGI and how it has, and has not, been used safely and effectively. This article reviews that history of UVGI for air disinfection, starting with its biological basis, moving to its application in the real world, and ending with its current status.

Five millennia of wound care products--what is new? A literature review.

The first wound an wound treatments were described five millennia ago. Since then, various principles of wound care have been passed on from generation to generation. In contrast to large numbers of general technological inventions over the last 100 years, progress beyond ancient wound care practices is a recent phenomenon. It is essential to know the historical aspects of wound treatment (both successes and failures) in order to continue this progress and provide future direction. A survey of the literature shows that concepts such as "laudable pus" persisted for hundreds of years and that lasting discoveries and meaningful progress did not occur until grand-scale manufacturing and marketing started. Landmarks such as understanding the principles of asepsis/antisepsis, fundamental cellular research findings, knowledge about antibiotics/antimicrobials, moist wound healing, and the chemical and physical processes of wound healing have provided the foundation to guide major developments in wound management, including available evidence-based guidelines. Although research regarding interaction of basic wound management principles remains limited, the combined efforts of global research and clinical groups predict a bright future for improved wound management.

Antonio Grossich- on the centenary of his introduction of iodine tincture painting in the preoperative infection control.

The article presents the life and achievements of Doctor Antonio Grossich, the head of the Department of surgery and gynecology of the Civic hospital in Rijeka. He wrote several literary works, but deserves to be remembered for his clinical and experimental work on antiseptic and aseptic procedure. He introduced the method of painting the operative field with 10% iodine tincture at first in traumas, then in general surgery. The method, for its rapidity, efficacy and not expensive had soon a worldwide success. He also participated actively in the political life of Rijeka before and after the World War I.

Early attempts at sterilization: BJN 100 years ago.

The cleanliness of the skin for operations was a big issue 100 years ago, and it is fascinating to read different accounts of how surgeons tackled the problem and came up with their solutions. Mr Stretton, a senior surgeon to the Kidderminster Infirmary and Children's Hospital, writing in the BJN at the time, said:

[A predicted epidemic. The appearance of cholera in 1832 in southwest France]. / Une épidémie annoncée. L'apparition du choléra en 1832 dans le sud-ouest de la France.

In 1832 the epidemic cholera provoked the fear of a new plague on the banks of the Garonne and the administrative measures to struggle against the illness as the sprawling epidemic could be delimited in three departments. The author describes the clinical pictures of the illness and underlines the prophylactic measures which followed from epidemics of previous centuries and lasted until pasteurism, the increasing hygiene and the apparition of chemical treatments.

[Changes in the therapy of pulpal diseases and periapical lesions according to the articles published in the journal Fogorvosi Szemle during the past 100 years (1908-2008)]. / A fogbélbetegségek és a fogbél következményes betegségeinek terápiájában (gyökérkezelés) bekövetkezett változások 100 éve a Fogorvosi Szemle közlemenyeinek tükrében (1908-2008).

Present review makes an attempt to summarize the Hungarian endodontic literature of pulpal and periodontal diseases, published during the past 100 years. The experimental examinations and clinical studies make it possible to follow the changes in the methods and in the medicines, used in the field of pulpal treatment. The overview gives us information about the problem of disinfection, shaping, measuring, and obturation of root canal.

Semmelweis and the aetiology of puerperal sepsis 160 years on: an historical review.

It is generally accepted that Professor Ignaz Semmelweis was the first to identify the mode of transmission of puerperal sepsis. However no appropriate statistical analysis of Semmelweis's data supporting his theory has been reported. Mean annual percent maternal mortality rates for the Allgemeines Krankenhaus and Dublin Maternity Hospitals (1784-1858) were analysed. The introduction of pathological anatomy at the Allgemeines Krankenhaus in 1823 was associated with increased mortality. After 1840 maternal mortality was higher in Clinic 1 which was staffed by male obstetricians and medical students who, unlike the midwives in Clinic 2, attended autopsies. The introduction of chlorine washing of the male clinicians' hands in Clinic 1 by Semmelweis in 1847 reduced mortality, whereas the cessation of handwashing after Semmelweis left Vienna in 1850 was associated with increased mortality. This statistical analysis supports Semmelweis's hypothesis that 'the cadaveric particles adhering to the hand had ... caused the preponderant mortality in the first Clinic'.