6 THE TONER LECTURES. 



and then it was found that suppuration in the hip-joint had 

 taken place. The third case was also one of fractured hume- 

 rus in an old gentleman over seventj' years of age, a tall and 

 heavy man, a colonel in the Indian army, who fell down a stone 

 staircase. No other important injuries were sustained, but the 

 bruising was extensive, and a large amount of extra vasated 

 blood existed at the seat of fracture, where suppuration occurred, 

 and he died from exhaustion ; his general condition precluded 

 amputation. 



The occurrence of deep bruising by which the vitality of 

 the tissue is seriously impaired, together with the presence of' 

 extravasated blood, which, under such circumstances, will 

 sometimes break down, is, I believe, a correct and sufficient 

 explanation of the occurrence of suppuration in these subcu- 

 taneous injuries. The suppuration in these cases is clearly 

 independent of the admission of air, and therefore does not 

 admit of explanation by the germ-theory so strongly advo- 

 cated by Professor Lister of Edinburgh. Professor Lister, 

 indeed, thinks that we should effectually guard against the 

 occasional suppuration which is known to occur after subcu- 

 taneous operations, by adopting the antiseptic method, and 

 operating under the carbolic or antiseptic spray. My belief is, 

 however, that the antiseptic principle sui)eradded to the sub- 

 cutaneous would afford no additional protection, and to me it 

 seems like gilding pure gold. Although I admit the great 

 value of Prof. Lister's antiseptic method, especially when 

 carried out by himself with all the attention to the minutest 

 details which he bestows, and have no hesitation in stating 

 that when in Edinburgh, a year ago, I witnessed a larger 

 number of good results after capital operations, such as ampu- 

 tations, excisions, ligature of arteries, etc., than I have ever 

 seen before under any other treatment, I cannot but think 

 that the only cases at all connected with the class of opera- 

 tions we are now considering, to which it would be applicable, 



