ON THE ANTISEPTIC PRINCIPLE IN THE 

 PRACTICE OF SURGERY 



A paper read before the British Medical Association in Dubhn on August 9, 1867. 

 [British Medical Journal, 1867, vol. ii, p. 246.] 



In the course of an extended investigation into the nature of inflammation, 

 and the healthy and morbid conditions of the blood in relation to it, I arrived, 

 several years ago, at the conclusion that the essential cause of suppuration in 

 wounds is decomposition, brought about by the influence of the atmosphere 

 upon blood or serum retained within them, and, in the case of contused wounds, 

 upon portions of tissue destroyed by the violence of the injury. 



To prevent the occurrence of suppuration, with all its attendant risks, was 

 an object manifestly desirable ; but till lately apparently unattainable, since 

 it seemed hopeless to attempt to exclude the oxygen, which was universally 

 regarded as the agent by which putrefaction was effected. But when it had 

 been shown by the researches of Pasteur that the septic property of the atmo- 

 sphere depended, not on the oxygen or any gaseous constituent, but on minute 

 organisms suspended in it, which owed their energy to their vitality, it occurred 

 to me that decomposition in the injured part might be avoided without excluding 

 the air, by applying as a dressing some material capable of de5tro3'ing the life 

 of the floating particles. 



Upon this principle I have based a practice of which I will now attempt to 

 give a short account. 



The material which I have employed is carbolic or phenic acid, a volatile 

 organic compound which appears to exercise a peculiarly destructive influence 

 upon low forms of life, and hence is the most powerful antiseptic with which 

 we are at present acquainted. 



The first class of cases to which I applied it was that of compound fractures, 

 in which the effects of decomposition in the injured part were especially striking 

 and pernicious. The results have been such as to establish conclusively the 

 great principle, that all the local inflammatory mischief and general febrile dis- 

 turbance which follow severe injuries are due to the irritating and poisojiing influence 

 of decomposing blood or sloiig/is. For these evils are entirely avoided by the 

 antiseptic treatment, so that limbs which otherwise would be unhesitatingly 

 condemned to amputation may be retained with confidence of the best results. 



