269 



IV. — Bacteriology of Septic War Wounds. 

 By K. W. GOADBY. 



Bead March 21, 1917. 



Plates XIX to XXII and 1 Text-Fig. 



I DO not this evening propose to enter into a controversial dis- 

 cussion of the medical technicalities involved in the bacteriology of 

 the septic wound. What I do propose, with your indulgence, is to 

 briefly outline some of the problems associated with the bacteriology 

 and pathology with which we are daily confronted ; to indicate to 

 you the methods by means of which we are seeking to unravel these 

 problems to combat bacterial ravages and promote the healing and 

 return to health of our wounded soldiers. 



In the practical working out of these problems I early found 

 that new technical methods must be devised to deal with situations 

 with which we were more or less unfamiliar, the septic wounds of war 

 differing in divers ways from the injuries usually met with in civil 

 practice. Chief amongst these differences are found to be (1) the 

 large number of anaerobic bacteria met with in the majority of 



EXPLANATION OF PLATE XIX. 



Fig. 2. — Pus-film from a septic wound, four days after injury. Commencing 

 sporulation is seen, and almost complete disintegration of leucocytes. 

 Stained Gram, x 1000. 



,, 3. — End-sporing organism isolated from the same case ; forty-eight hours' 

 egg-agar. Stained Gram, x 1000. 



,, 4. — Invasion of wounded tissue, showing mixed infection ; material removed 

 several weeks after original injury. Both cocci and Gram-positive 

 bacilli [B. perfringens) were present ; sporing anaerobes were also 

 isolated, x 1000. 



„ 5. — Granulation (partially organized) tissue from between fractured tibia and 

 fibula, three months after original injury. The irregular loose loculi 

 form spaces in which the original infecting organisms become 

 sequestrated, and remain ready to take on fresh activity if the tissue 

 is subsequently disturbed. Stained hsematoxylin-eosin. x 500. 



,, 6. — Section in the immediate neighbourhood of acute gas gangrene. A large 

 number of organisms are seen, naany of them situated inside the poly- 

 morphonuclear cells. Stained Gram-Weigert. x 500. 



„ 7. — Section of tissue from the same situation as fig. 6, but stained haematoxylin- 

 eosin, showing the polymorphonuclear activity ; but this stain does 

 not show the infecting bacteria, x 500. 



