Auvard, writing to the Annals of Gynec., April, 1888, says, while before
the days of antiseptics it was better for a woman to be delivered in the
street than in a hospital, the hospital ward is now less dangerous than
the isolated lying-in chamber of the out-patient obstetric service. He
points out the importance of improving the resisting power by use of
tonics before the labor, in debilitated patients. In Auvard’s practice
every woman takes a thorough bath at the beginning of labor. The whole
vulvar and vaginal surfaces and cervical canal are sterilized before
expulsion begins, before obstetric wounds are developed. Asepsis before
and during the birth is more effectual than the use of antiseptics at
the close of labor and renders the latter unnecessary.
Sublimate soap and the sublimate solution, with which this soap makes a
lather, are well rubbed into the surfaces to be cleansed by aid of the
fingers. The dangers of sublimate poisoning do not obtain while the
surfaces are intact.
In the event of septic developments during the puerperal period he
thinks sublimate irrigation insufficient for genital antisepsis. The
vulva and vagina should be scrubbed by aid of the fingers with the
sublimate soap and solution. The uterus should be scraped with the
curette. Auvard has devised for this purpose a curette with a hollow
stem through which a stream of the antiseptic solution is kept flowing
during its use. [The mercurial salts may be replaced with a 1:1000
hydronaphthol solution for use within the passages after labor, though
the danger from the former antiseptic may be greatly diminished by
washing away the mercurial with a final injection of plain boiled
water.]