IN THE PRACTICE OF SURGERY 45 



absorption or otherwise. Should this particular branch of the subject yield 

 all that it promises, should it turn out on further trial that when the knot is 

 applied on the antiseptic principle, we may calculate as securely as if it were 

 absent on the occurrence of healing without any deep-seated suppuration ; 

 the deligation of main arteries in their continuity will be deprived of the two 

 dangers that now attend it — namely, those of secondary haemorrhage and an 

 unhealthy state of the wound. Further, it seems not unlikely that the present 

 objection to tying an artery in the immediate vicinity of a large branch may 

 be done away with ; and that even the innominate, which has lately been the 

 subject of an ingenious experiment by one of the Dublin surgeons on account 

 of its well-known fatality under the ligature from secondary haemorrhage, 

 may cease to have this unhappy character, when the tissues in the vicinity of 

 the thread, instead of becoming softened through the influence of an irritating 

 decomposing substance, are left at liberty to consolidate firmly near an un- 

 offending though foreign body. 



It would carry me far beyond the limited time which, by the rules of the 

 Association, is alone at my disposal, were I to enter into the various applications 

 of the antiseptic principle in the several special departments of surgery. 



There is, however, one point more that I cannot but advert to — namely, the 

 influence of this mode of treatment upon the general healthiness of a hospital. 

 Previously to its introduction, the two large wards in which most of my 

 cases of accident and of operation are treated were amongst the unhealthiest 

 in the whole surgical division of the Glasgow Royal Infirmary, in consequence, 

 apparently, of those wards being unfavourably placed with reference to the 

 supply of fresh air ; and I have felt ashamed, when recording the results of my 

 practice, to have so often to allude to hospital gangrene or pyaemia. It was 

 interesting, though melancholy, to observe that, whenever all, or nearly all, 

 the beds contained cases with open sores, these grievous complications were 

 pretty sure to show themselves ; so that I came to welcome simple fractures, 

 though in themselves of little interest either for myself or the students, because 

 their presence diminished the proportion of open sores among the patients. 

 But since the antiseptic treatment has been brought into full operation, and 

 wounds and abscesses no longer poison the atmosphere with putrid exhalations, 

 my wards, though in other respects under precisely the same circumstances as 

 before, have completely changed their character ; so that during the last nine 

 months not a single instance of pyaemia, hospital gangrene, or erysipelas has 

 occurred in them. 



As there appears to be no doubt regarding the cause of this change, the 

 importance of the fact can hardly be exaggerated. 



