were employed in the hope of destroying these microbes. At first, antiseptics such as carbolic acid and iodine were used, but they were found to be ineffective in preventing the spread of the infection. Then antiseptics of the chlorine group which were derived from bleaching powder came into vogue, and these were found to be much more useful, although their exact value was obscured by the great advances made in the surgery of the wounds at the same time. These chlorine antiseptics act very quickly on the microbes, but at the same time they are very rapidly destroyed in the wound, so that after about 10 minutes they have lost their antiseptic value. It was the common practice to instil these antiseptics into a septic wound every two hours in the hope of keeping up a constant supply of the anti- septic, but as the active agent is destroyed in about 5 or 10 minutes it follows that for the greater part of the time there was no antiseptic in the wound. Fleming has shown that in all probability the beneficial action of these so-called antiseptics was not in their power of destroying microbes but in their power of aiding the natural antiseptic defences of the body.
In the simplest form these chlorine antiseptics were solutions of hypochlorous acid (ensol) or sodium hypochlorite (Dakin's fluid), but later Dakin introduced more complicated organic preparations, such as chloramine T. and dichloramine T., which were more stable and contained a greater percentage of the active agent. These later applications have never attained the popularity of the simpler compounds.
Morison introduced into war surgery a procedure in which the wound, after being thoroughly cleansed, was rubbed over with a paste consisting of bismuth, iodoform and paraffin (Bipp). This obtained a considerable popularity, and it was supposed to act by virtue of the iodoform, which is not in itself an antiseptic, being broken down in contact with the blood fluids with the liberation of iodine. Experiments showed, however, that there was not sufficient iodine liberated to act as a lethal agent for bacteria in the body fluids, and it is probable that, like the chlorine antiseptics, this depended largely for its beneficial action on its power of aiding and conserving the natural defences of the body.
The last types of antiseptics to be introduced into war surgery were the aniline dyes. The power of some of these dyes as anti- bacterial substances had been previously investigated. Church- man had shown that gentian violet would kill many varieties of bacteria (those which stain with Gram's method) in a dilution of i in 1,000,000, or less, while it had little lethal action on other varieties which did not stain by Gram's method. Another dye, brilliant green, had been used in bacteriological technique for the isolation of typhoid bacilli, owing to its having a less lethal action on these than it had on the other and more common bacteria. Browning introduced into surgical practice another dye of the acridine series, called by him flavine or acriflavine, which had been originally prepared by Benda at Ehrlich's > - suggestion for the destruction of trypanosomes (the parasites of sleeping-sickness). Flavine differed from all the other antiseptics in that it acted more powerfully in the presence of blood serum than it did in water. Great hopes were therefore entertained that it would be able to deal effectively with the bacteria in an infected wound. It was found, however, that it was rapidly fixed by the body tissues and by the dressing of the wound, and in practice it was not found to have advantages over the other antiseptics in common use.
Towards the end of the war all the chemical antiseptic solutions fell more or less into disuse and more reliance was placed on efficient surgery and the natural antiseptics of the body. The greatest advance in the treatment of infected wounds was the efficient cleansing of the wound, the removal of all dead tissues, and the immediate closing of the wound so that the natural antiseptic defences could exercise their functions to the greatest advantage. It was found that when physiological salt solution was used the results of this procedure were as good as when chemical antiseptics were employed.
Since the war conditions have been removed antiseptics have largely disappeared from surgical practice, and a return has been made to " aseptic " methods, in which microbes are, as far as possible, excluded from the wound and the natural defences of the body are left to deal with the few microbes which may gain access. (A. FL.)
ANTOINE, ANDRÉ (1858- ), French actor-manager (see
2.148), opened in 1897 his Theatre Antoine in Paris, which for 10
years he made famous as a home of modern realistic drama,
playing in particular the works of Brieux, Hauptmann and
Sudermann, and staging a French version of King Lear. He
returned to the management of the Odeon in 1906 and there
produced Julius Caesar, Coriolanus and a large number of
classical and modern dramas, but he retired in Feb. 1914. He
was subsequently engaged in writing his memoirs.
ANTWERP, Belgium (see 2.155). Pop. (1914) 313,833; but, including Borgerhout (52,126) and Berchem (32,257), total pop.
398,216. The projected grande coupure, or cutting through the
neck of the loop in the river Scheldt immediately below Antwerp,
was abandoned, and, in place of this scheme, three extensive
wet-docks were constructed between 1903-14. In 1913, 7,142
vessels of aggregate tonnage 28,270,000 entered the port as
compared with 6,095 of 19,662,000 tons in ,1905. The decision,
taken in 1878, to change Antwerp from a fortress to a fortified
position by the construction of an outer line of 15 forts and bat-
teries at a distance varying from 6-9 m. from the enceinte was
nearly completed at the outbreak of the World War in 1914.
A proposal to connect the two banks of the river by a tunnel
under the Scheldt was about to be taken in hand in 1921.
On Aug. 17 1914 the Belgian Government left Brussels for Antwerp, and the Belgian army withdrew before the advance of von Beseler's army behind the fortified lines. The bombard- ment of Antwerp began on Sept. 28 and lasted until Oct. 9, when the city surrendered. Nine-tenths of the population fled, mostly to Holland. Some 300 houses (especially in the Marche- aux-Souliers, the Avenue d'Amerique and the suburbs near the forts) were destroyed, but the older and more important public buildings (the positions of which were known to the Germans) escaped damage. Under the harsh occupation of the Germans, Antwerp remained practically a dead city. On Nov. 19 1918, the King and Queen of the Belgians entered the city in state and attended a Te Deum in the cathedral. In Aug.-Sept. 1920, the Olympic Games (7th Olympiad) were held in a newly constructed stadium at Beerschot just outside the city.
THE SIEGE OF 1914
In the middle of the 19th century, the steady development of the city and its naval installations had made it necessary to enlarge the fortress, and so disquieting were the ambitions of the new French Empire that it was decided to erect a national keep for the defence of Belgium at Antwerp. The new fortress was accordingly built between 1859 and 1870 under the direction and after the plans of the celebrated Belgian engineer, Gen. Brialmont.[1]
It comprised: (l) A line of detached forts (forts No. I to No. 8 and Fort Merxem on the right bank; Forts Cruybeke, Zwyndrecht and Ste. Marie on the left) placed at a distance of about 2\ to 3 m. from the agglomeration of buildings, so as to protect these against bombardment. These forts, about 2,200 yd. apart, built both in masonry and in earth, were big batteries which embodied the. lessons of the siege of Sevastopol. (2) A polygonal enceinte carried round the edge of the city.
With over 1,000 guns the entrenched camp of Antwerp was considered the most powerful fortress in the world. After the lessons of the sieges of 1870-1 and 1877, however, it was con- sidered necessary to extend the fortress's sphere of influence still further, in order to facilitate the operations of the Belgian army when manoeuvring under its protection, and especially to enable it to make sorties in the direction of Brussels or in that of Louvain without being cut off. As the water-line formed by the rivers Nethe and Rupel considerably impeded such operations between Lierre and the Scheldt (that is to say, on that part of the front which was most convenient for them), the forts of
- ↑ A general plan of Brialmont's fortress and details of its enceinte will be found in 10.693-694.
