248 AN ADDRESS ON THE EFFECT OF THE ANTISEPTIC TREATMENT 



After going into details regarding the various forms of hospital disease, he 

 proceeds to describe the greatly increased success that now attends the treatment 

 of some injuries. ' As to accidental deep wounds, large lacerated wounds of 

 the scalp, contused wounds with smashing of hand or foot, compound fractures 

 or wounds of joints, I almost invariably have them heal without any bad 

 symptoms, by means of antiseptic dressing and drainage-tubes. Any case of 

 this sort will almost certainly recover if there is no complication of shock, or 

 gangrene of the limb, or contusion of internal organs.' He next speaks of the 

 change which has taken place in the results of operations, such as amputations 

 and excisions, and adds, ' In short, I think I am right in saying that patients 

 very seldom die from an operation. If they do die, it is not the operation that 

 kills them, but the disease that existed previously to the performance of the 

 operation.' Lastly, he alludes as follows to abscesses connected with diseased 

 bone. * What until the last few years proved the most difficult to deal with, 

 are the abscesses which are connected with bone- disease. But now I think 

 we may safely cut into them, if we only persevere in the antiseptic treatment 

 for a sufficiently long time. By means of careful dressing, drainage-tubes, 

 and the antiseptic spray whenever the dressing has to be changed, we get over 

 those accidents of septicaemic poisoning which formerly almost invariably 

 followed incision into these collections. But I am equally sure that, if I do 

 not carry out the antiseptic treatment to its full extent, it is of no use whatever 

 to apply carbolic acid to a wound, at least as regards the dangers that always 

 accompany putrefaction.' 



I come now to what I witnessed in the course of my recent travel in Germany, 

 and I shall speak only of those hospitals into which antiseptic treatment has 

 been introduced. Of these, the first I saw was Munich. The large Allgemeines 

 Krankenhaus there has been until lately increasingly unhealthy ; pyaemia was 

 very frequent ; and hospital gangrene, which made its appearance in the year 

 1872, had become annually a more and more frightful scourge, until last year 

 it had reached the astounding proportion of 80 per cent, of all wounds that 

 occurred in the hospital, whether accidental or inflicted by the surgeon. And 

 not only was it thus extremely frequent, but was in a very severe form, produced 

 frightful ravages, often caused death, and led to patients who recovered being 

 retained an inordinately long time in the hospital. But, from the time when, 

 at the beginning of the present year, efficient antiseptic treatment was brought 

 into operation by Professor Nussbaum, they have not had one single case of 

 hospital gangrene. At the time when I was at Munich, they were doubtful 

 whether they had had one case of pyaemia ; erysipelas, formerly very prevalent 

 and severe, was rare, and, when it did occur, was in a very mild form ; and 



