134 EFFECTS OF THE ANTISEPTIC TREATMENT 



stump, and, advancing insidiously in all directions, defied my best attempts 

 to check it, and had reached beyond the sternum before the poor fellow sank 

 exhausted from its effects. 



The contrast under the antiseptic system has been most striking. For the 

 first nine months, as before mentioned, we had not a single case of the disease. 

 Since that time it has shown itself now and then, but in a mild form, invariably 

 yielding to treatment, never occurring in recent cases, but only in old sores 

 weakened by the influence of surrounding cicatrix. But even this has been 

 very rare, and I do not recollect more than one example of it during the last 

 year. In short, hospital gangrene, like pyaemia and erysipelas, may be said 

 to have been banished by the antiseptic system. 



Such being the case, I have insensibly relaxed in different wa^^s my former 

 vigilance regarding the wards. I have allowed cribs for children to be intro- 

 duced without remonstrance, having practically the effect of increasing the 

 number of beds for adults ; and I have, in the pressure of deficient accommo- 

 dation, often permitted two children to be put in one bed — a thing which 

 I should formerly not have thought of. I used to make a point of having both 

 the large fires in each ward kept alight night and day during the heat of summer, 

 for the sake of making the ventilation as perfect as possible. But during the 

 last season the nurses were left to follow their inclination, and keep only one 

 of the fires lighted. I may add that my wards have remained during the three 

 years without the annual cleaning, which used to be thought essential. On 

 my asking the superintendent the reason for the omission, he replied that, as 

 those wards had continued healthy, and there was nothing dirty in their appear- 

 ance, it had seemed unnecessary to disturb them. Thus the wards have been 

 in various respects subjected to greater trial than usual, and yet have remained, 

 as I may repeat without any exaggeration, models of healthiness. 



That such should have been the case under the unfavourable hygienic 

 conditions above referred to seems at first sight very surprising. The imme- 

 diate vicinity of a burying-ground such as has been described, together with the 

 position of the wards at the base of a hospital of four stories, with the air con- 

 fined by neighbouring buildings, may seem conditions utterly inconsistent with 

 health in the patients. That these circumstances were very unfavourable is 

 undoubtedly true ; and that they were highly injurious before the antiseptic 

 period seems clearly indicated by our experience. But a little consideration 

 will show that it is not unreasonable to suppose them of secondary importance — 

 as aggravators of the evil, rather than the essential causes of it. The corpses in 

 the places of sepulture beside the infirmary were for the most part covered by 

 at least some inches of earth, which has a most powerful effect in checking the 



