362 SURGERY 



duction of antiseptic surgery. In the Pennsylvania Hospital, Norris 

 has made a statistical report of the compound fractures treated 

 between the years 1839 and 1851. During that time there were 

 116 cases of compound fractures of the leg and thigh (excluding 

 those cases requiring amputation) with 51 deaths, thus giving a 

 rate-mortality of 44 %. In the New York Hospital during the same 

 period there were treated 126 cases of compound fracture of the 

 leg and thigh (excluding those cases requiring amputation) with 

 61 deaths, thus giving a rate of mortality of 40 %. In the Obu- 

 chow Hospital reports of St. Petersburg there are 106 cases of 

 compound fracture with a mortality of 68%. In Guy's Hospital, 

 from 1841 to 1861, there were reported 208 cases of compound 

 fractures with 56 deaths, giving a mortality of about 28%. Bill- 

 roth reports from surgical clinics of Vienna and Zurich 180 cases 

 of compound fractures (excluding cases of amputation), with a 

 mortality of 31 % from septopyemia. Now, after the introduction 

 of antiseptics, a study of Billroth's table of compound fractures 

 shows a reduction in the death-rate to about 3 %. The influence, 

 therefore, of antiseptics has caused the death-rate to fall from 68 % 

 to about 3 %. In my personal report of 1000 cases, the fractures 

 of the extremities only are compared, as has been done in all of 

 the above tables; there is no death from septopyemia, and thus 

 the rate of mortality from blood-poisoning is now reduced from 68 % 

 to zero. It may be said, therefore, that pyemia and septicemia, 

 which formerly destroyed as many as 68 % of compound fractures, 

 have been practically eliminated. 



The science of surgery has at last demonstrated to the world 

 that it has fairly met these demons of destruction, and that it has 

 conquered them. Without doubt, the means of warfare have been 

 found in the establishment of bacteriologic laboratories, for with- 

 out these institutions the discoveries that affect the happiness and 

 mortality of the human race could not have been made. For my 

 own part, I remained a skeptic to the germ-theory of inflammation 

 until the Carnegie Laboratory afforded me an opportunity to work 

 out this great problem. The reduction of the death-rate from 68 %, 

 which half a century ago was considered a brilliant achievement, 

 and a result which was thought worthy of publication, to that of 

 a cipher, represents what surgery has done for the amelioration of 

 human suffering and the preservation of life. These statistics afford 

 us the most startling and impressive lesson of what surgery has 

 done. It has lessened suffering, it has annihilated pain, it has saved 

 limbs, it has conquered sepsis, it has saved life. Surely nothing 

 could be added to show more clearly the triumphant march of the 

 onward progress of the grandest profession in the world. 



Compound fractures of the skull require surgical interference 



