556 



NATURE 



[February 22, 19 12 



bed-buf? had been indicated by Major Rogers as the 

 probable agent in the transmission of the disease, 

 while Major Donovan considered it more probable that 

 another bu>jf, Conorltinus rubrofasciatiis, was the 

 means of disseminating^ the parasite. The bare fact 

 that the parasite developed in the bed-bug so far as 

 its flagellated, herpetomonad stage was not in itself 

 a decisive proof that the bed-bug was responsible for 

 its transmission ; and from the telegram received it 

 can only be supposed that Captain Patton has com- 

 pleted his former investigations on the development of 

 the parasite, and has obtained definite experimental 

 proof of its transmission by the agency of the bed- 

 bug. 



The recent investigations of Dr. Wenyon on the 

 allied parasite, Leishmania tropica, the cause of 

 Oriental sore, make it probable that in this case the 

 transmitting agent is a mosquito or a sand-fly (Phlebo- 

 tomus sp.), sometimes also a house-fly, which may 

 carrv the infection mechanically, i.e. not as a true 

 host'. In North Africa and Southern Europe another 

 species of these parasites is known, which is believed 

 by its discoverer, Dr. Nicolle, to be primarily a para- 

 site of dogs, and to be transmitted by some means 

 from dogs to human beings, especially children, 

 whence it has been given the name L. infantum. 

 Dr. C. Basile in Italy has succeeded recently in 

 transmitting this species experimentally by means of 

 fleas. Further details of Captain Patton 's investiga- 

 tions will be awaited with interest. 



B' 



LORD LISTER, O.M., F.R.S. 



|Y the death of Lord Lister, the world has lost 

 one of its greatest men, and one who, without 

 any question, conferred more benefits on humanity 

 than any man had ever done before. His great 

 achievernent was no doubt the revolution which he 

 carried out in the science and practice of surgery 

 by his investigations into the causes of septic disease, 

 and one has only to look back at the state of surgery 

 up to the time when he began his work to gain 

 some idea of the enormous advance which foUow^ed. 



From the earliest ages the fatal consequences of 

 wounds, whether occurring accidentally or as a result 

 of an operation, have occupied the minds of all those 

 who had to do with their treatment, and all sorts 

 of attempts have been made to obviate these evils. 

 The practice of the ancient writers was not to keep 

 away noxious agents which interfered with the heal- 

 ing of wounds, as was Lister's conception, but to 

 make the wound heal, and substances were applied to 

 make the flesh grow, others to make the growing 

 flesh firm, and others again to make the wound cica- 

 trise. Amid these attempts, the tendency of the 

 wound itself towards healing was almost entirely lost 

 sight of ; nevertheless, there were surgeons who, 

 from lime to time, were bold enough or had insight 

 enough to protest against these views and to point 

 out that it is to nature itself that one must attribute 

 the ultimate healing of the wound. However, but 

 little attention was paid to these writers, and the 

 practice of treating the supposed poisonous state of 

 the surface of the wound and of inducing healing by 

 various applications still held its own. 



Paracelsus was the first who came nearest the 

 modern ideas ; he supposed that there is a juice dis- 

 tributed in the body which keeps the various tissues 

 in good health and repairs them when injured, and 

 he held that the whole aim of the surgeon ought to 

 be to prevent alterations in this liquid, these altera- 

 tions resulting mainly from contact with air. Medical 

 applications are only of use in so far as they preserve 

 this juice and prevent its corruption. 



NO. 2208, VOL. 88] 



Similar views were held by Ambroise Par6, and 

 was chiefly by the writings and teachings of these tv 

 men that the position of nature as an agent in li' 

 wounds was more fully recognised. 'ITie tei 

 after that time was to look on the contact of i 

 with the wound as the source of the main ti 

 and after the chemical constitution of the air \\ 

 discovered, it was the oxygen in the air which w.. 

 chiefly blamed for the decomposition which took pUn 

 in the wounds ; indeed, this view was still held v< i 

 widely when Lister began his researches on the pi 

 vention of sepsis. 



The first result of these views was that enormoi 

 quantities of dressings were applied over the woun(. 

 and left unchanged for a long time, with a view 



excluding the air. At the ^nd of the eighteeni: 

 century and the beginnin|||^K the nineteenth, oih' 

 methods of treatment we^^Kiployed, which yieldi 

 very much better results than the older ones. Or 

 of the earliest of these methods was simple wat- 

 dressing, and this was followed by irrigation, by tl 

 use of the water-bath, and in some cases by tl. 

 addition of various antiseptic substances to the wait 

 so employed. Others came to the conclusion that it 

 was best to leave the wounds open, others that heal- 

 ing by scabbing should be promoted, while the fear 

 of the effect of air on wounds led to the introduc- 

 tion, in 1816, of subcutaneous surgery. About the 

 middle of last century various antiseptic substances 

 were a good deal employed, especially in France — 

 balsams, chlorine, alcohol, chloride of zinc, iodine; 

 and, very shortly before Lister's first publication, 

 carbolic acid was advocated by Lemaire as an applica- 

 tion to wounds. None of these antiseptic substances 

 were, however, used on any definite scientific ground 

 or with any definite method, and the result was, 

 though a certain amount of improvement may have 

 occurred, nothing like that which was brought about 

 by Lister's systematic work was attained. 



It is quite unnecessary to go into the details of 

 that work ; that has already been done in these 

 columns and elsewhere. Lister was the subject of 

 an article in the Nature series of " Scientific 

 Worthies" on May 7, 1896 (vol. liv., p. i), and his 

 collected works were reviewed in Nature of Februan." 

 17, 19 10. It may be said that, from the time Lister 

 was a student, his mind had been occ ' ' 

 with the terrible fatal results which so con-: 

 followed operations, however perfectly they >^^i 

 conducted, and he had definitely come to the conch, 

 sion that these troubles were associated with, an 

 indeed the result of, the putrefactive changes whic: 

 occurred in the blood and serum in the wound. H 

 felt that if only these putrefactive changes could !•■ 

 avoided, the dangers which resulted would, in ;i' 

 probability, also disappear. So long as the view w.i~ 

 held that these changes were due to the contact of tlv 

 oxygen of the air with the discharges, the matt* 

 seemed hopeless, because it seemed impossible to per 

 form an operation under conditions which woul 

 exclude the oxygen of the air. When, however 

 Pasteur in his work on "Spontaneous Generation, 

 demonstrated that the oxygen of the air was quii' 

 unable to cause fermentative changes in organic fluid- 

 and that these changes were due to living particl« 

 which fell into these fluids from the air, these particl' - 

 belonging to the class of bacteria, the outlook becan: 

 much more promising, for it was quite a difl"erer 

 matter to have to do with particles which were simpi 

 floating in the air, and were often in small number- 

 and even entirely absent, than with gaseous sub- 

 stances which could penetrate ever\'where. 



Two courses were open in dealing with such par- 

 ticles, namely, to exclude them altogether, as in th- 



