BEFORE AND AFTER LISTER 167 



of 97.4 per cent. Few of you probably have seen even 

 one such case. I have given a matter-of-fact description 

 of it in my "Surgical Reminiscences," but if you wish to 

 see it sketched by a master's hand read that most touch- 

 ing and beautiful of all medical stories I know "Rab 

 and His Friends," by dear old Dr. John Brown, of Edin- 

 burgh. He vividly paints the sudden change in the wound, 

 the pulse, the eye, the mind, on and on, worse and worse, 

 until "that animula, blandula, vagula, hospes comesque 

 was about to flee." 



Tetanus had a mortality of 89.3 per cent. Of amputa- 

 tions at the hip-joint 83.3 per cent. died. Trephining had 

 a mortality of 61 per cent. Even of ligations of the fe- 

 moral artery, 374 in number, 281 died, or over 75 per 

 cent. Of 2,235 cases of secondary hemorrhage, 61.7 per 

 cent. died. Hospital gangrene, of which there were sev- 

 eral hundred cases, had only a mortality of about 25 per 

 cent., because we early learned the correct though empiri- 

 cal treatment, viz., the application of the actual cautery, 

 pure bromine, strong nitric acid or similar destructive 

 agents which killed the germ, whatever it was, and ar- 

 rested the disease. 



The Franco-Prussian War of 1870-71 was marked by 

 notable progress in military sanitation in the German army, 

 yet in spite of this there were 74,205 cases of typhoid 

 fever, almost 10 per cent, of the entire average strength 

 (788,213) and 8,904 deaths, a mortality of 11.3 per cent. 



Surgically the results were nothing to boast of. Lis- 

 terism had as yet made but little progress in the profes- 

 sion. Carbolic acid was used to some extent, but there 

 was no thorough antiseptic system, for the germ theory 

 was as yet neither understood nor accepted. 



Of tetanus there were 294 cases, and 268 died, a mor- 

 tality of 91.1 per cent. 



The total of the four selected amputations was 2,194 

 with 1,196 deaths, a mortality of 54.5 per cent. over 

 one-half. 



