158 FURTHER EVIDENCE ON ANTISEPTIC SYSTEM OF TREATMENT 



viction of the truth of the germ theory of putrefaction, which, unfortunatety, 

 is in this countr}^ the subject of doubts such as I confess surprise me, considering 

 the character of the evidence which has been adduced in support of it. Yet, 

 without this guiding principle, many parts of the treatment would be unmeaning ; 

 and the surgeon, even if he should attempt the servile imitation of a practice 

 which he did not understand, would be constantly liable to deviate from the 

 proper course in some apparently trivial but essential detail, and then, ignorant 

 of his own mistake, would attribute the bad result to imperfection of the method. 

 For my own part, I find that, in order to approach more and more to uniform 

 success, it is necessary to act ever more strictly in accordance with the dictates 

 of the germ theory. Failure on the part of those who doubt or disbelieve it is 

 therefore only what I should expect. 



Another great cause of failure undoubtedly is, the careful attention necessary 

 in order to exclude, from first to last, the subtle putrefactive organisms that 

 people the atmosphere and form part of the dust which adheres to all exposed 

 objects. The germ theory, while it furnishes the clue to success, affords ample 

 explanation of failure. I believe I do my professional brethren in Britain no 

 more than justice when I say that if they felt anything like the assurance 

 expressed in Professor Saxtorph's words, ' the reward is certain,' they would 

 not grudge a greater degree of trouble than the antiseptic treatment demands. 

 And, in truth, when once a surgeon has become thoroughly initiated into the 

 practice, it is in most cases a saving of trouble. Thus I have at present a patient 

 about to leave the infirmary three weeks after the removal of the entire mamma 

 for scirrhus, all the axillary glands having been at the same time cleared out 

 after division of both the pectoral muscles, so as to permit the shoulder to be 

 thrown back and the axilla freely exposed, as is done in the dissecting-room — 

 a practice which I have for some years adopted where the lymphatic glands 

 are affected in that disease. In this case a great deal of care was certainly 

 required for the first few days ; but after a week the dressings were only changed 

 once in three days, and when a fortnight had elapsed, cicatrization being almost 

 perfect, a week was allowed to pass without any interference. Hence, on the 

 whole, the labour was considerably less than with ordinary treatment, and 

 a very much greater amount of pains would have been amply repaid by the 

 beautiful linear cicatrix, formed without the occurrence of one drop of pus, 

 and without any serious constitutional disturbance. This, however, was an 

 instance in which an unusual degree of care was requisite ; for the axilla is one 

 of the most difficult situations in the body to guard antiseptically, and I have 

 only myself learnt quite recently the art of doing this, as I believe, with security. 

 But in most cases the details of the treatment are not troublesome to execute 



