BEFORE AND AFTER LISTER 185 



should still be practising the very limited surgery of the 

 6o's. Every year thousands whom now we restore to life 

 and health would still be dying. 



What now are the prospects of Listerism in the present 

 horrible war? I have so far used the term "antisepsis." 

 Asepsis is a later and a natural development of antisepsis 

 and in civil life is, of course, preferable. The under- 

 lying and enduring principle of Listerism the germ theory 

 is the same in both. There is no fundamental antago- 

 nism, but really a fundamental agreement between the two 

 methods. 



In the present war the surgeons whose papers I have so 

 far read are almost a unit in favor of the antiseptic rather 

 than the aseptic treatment of the wounded. They are 

 right in my opinion, and the reason is plain. Compara- 

 tively few of the wounded reach hospitals with uninfected 

 wounds. Mild wounds, and even in some cases severe 

 ones, if they can be dressed soon after being inflicted, 

 heal readily. 



Sir Anthony Bowlby's 21 striking description of the con- 

 ditions in the trenches shows the difficulties very clearly: 



In this trench warfare, if a man is hit, he often 

 falls into filthy mud and water, which may be three 

 feet deep or more. The trench is only two and a 

 half feet wide. It is night, you can only grope about 

 in thf dark and can do no dressing of any kind, for 

 you can't even get any clothes off in the dark, and 

 in so cramped a space, and you must try to get the 

 man away to a "dressing station" half a mile distant, 

 and thence to a field ambulance. If it is daylight, 

 you can't get the man out of the trench at all, and 

 he may have to be kept there for many hours, because 

 he would certainly be killed if he were got out of the 

 trench. And the water in the trenches is hopelessly 

 polluted and soaks his clothes and his wound. Large 

 . Am. Med. Ass., April 10, 1915, p. 1257. 



