318 DR. WILLIAM ROBERTS. 



Dr. Biirdon Sanderson has given the appropriate name of 

 pyrogen. It is the only known substance which produces a 

 simple uncomplicated paroxysm of fever — beginning with a 

 rigor, followed by a rise of temperature, and ending (if the 

 dose be not too large) in defervescence and recovery. 



2. We know further, from the evidence I have laid before 

 you, that decomposition cannot take place without bacteria, 

 and that bacteria are never produced spontaneously, but 

 originate invariably from germs derived from the surround- 

 ing media. We are warranted by analogy in regarding 

 pyrogen as the product of a special fermentation taking place 

 in decomposing albuminoid mixtures, but we cannot name 

 the particular organism nor the particular albuminoid com- 

 pound which are mutually engaged in the process. 



3. In the third place, we know that when a wound becomes 

 unhealthy, as surgeons term it, the discharge become offen- 

 sive — in other words, decomposed — and when examined 

 under the miscroscope they are found to swarm with organ- 

 isms resembling those found in all decomposing fluids. 

 Meanwhile the patient becomes feverish, and suffers from the 

 train of symptoms which we call septicasemia. 



It is a natural inference that what takes place in decora- 

 posing blood or muscle in the laboratory takes place also in 

 the serous discharges and dead tissues of the wound. These 

 become infected from the surrounding air, or from the water 

 used in the dressings, with septic organisms ; on that follows 

 decomposition and the production of the septic poison, or 

 pyrogen ; the poison is absorbed into the blood, and sep- 

 ticaemia ensues. 



It was the distinguished merit of Lister to perceive that 

 these considerations pointed to a means of preventing sep- 

 ticaemia. He argued that if you could prevent the access of 

 septic organisms to the wound, or destroy them there, you 

 would prevent decomposition, prevent the production of the 

 septic poison, and thus obviate the danger of septicaemia. It 

 is not within the scope of this address to describe the means 

 by which Lister attained this object, still less to pass judg- 

 ment on his practice, but I may be permitted to express iny 

 belief that the principle on which the treatment is founded 

 is unassailable. 



We should probably differ less about the antiseptic treat- 

 ment if we took a broader view of its principle. We are apt 

 to confound the principle of the treatment with Lister's 

 method of carrying it out. The essence of the principle, it 

 appears to me, is not exactly to protect the wound from the 

 septic organisms, but to defend the patient against the septic 



