250 AN ADDRESS ON THE EFFECT OF THE ANTISEPTIC TREATMENT 



out antiseptic treatment just in the same way as we do here. He gave an 

 antiseptic demonstration, to which he invited professors from various parts of 

 Germany ; and he certainly showed us a magnificent set of cases. It was, 

 I confess, somewhat gratifying to me that Professor Volkmann had obtained 

 his results without any of his assistants having visited Edinburgh. Seeing the 

 importance of the subject, he had worked in good earnest at the system, in 

 accordance with what he had read of my writings. He told me he had only 

 gradually got into the way of carrying out the system properly ; but I had 

 the satisfaction of seeing everything done exactly as we do here, and with results 

 of the most brilliant kind. That hospital was previously an extremely unhealthy 

 one. The wards are small and overcrowded ; each one has a water-closet 

 opening into it, and a large drain of the city runs under the wards. Indeed, 

 the building is so confessedly bad, that it has been condemned to demolition. 

 Pyaemia used to be exceedingly common there ; but, since the introduction of 

 antiseptic treatment, a change has taken place which I can best describe by 

 a quotation from a paper by Professor Volkmann himself ^ : — 



' I had hoped to have been able to publish before now the communication 

 which I made on the antiseptic treatment and Lister's mode of dressing, on 

 the occasion of the third Congress der deutschen Gesellschaft fiir Chirurgie ; 

 but as this has, unfortunately, not been the case, I may, perhaps, be allowed 

 to mention here a few facts for the purpose of showing how greatly the danger 

 of some forms of injury, which were formerly followed by a very high rate of 

 mortality, is diminished by this procedure. 



' Since the introduction of the antiseptic method into my clinique, now 

 exactly two years ago (at the end of November 1872), no single patient suffering 

 from a compound fracture, in which conservative treatment was attempted, 

 has died. Amongst this number are included even those cases in which con- 

 servative treatment was only resorted to because the patients would not give 

 their consent to amputation, and also those in which we at first underestimated 

 the severity of the injury, and afterwards intermediate or secondary amputation 

 had to be undertaken on account of haemorrhage or gangrene. The number 

 of compound fractures successfully treated without a single fatal result in our 

 hospital, which is old and always overcrowded, and offers the most unhealthy 

 hygienic conditions, amounts at present to thirty-one. Amongst these were 

 as many as nineteen compound fractures of the leg, in several instances much 

 comminuted, and often complicated with most severe bruising and laceration 

 of soft parts. There were also two compound comminuted fractures of the 

 patella, both of which recovered with movable joints. No case of pyaemia has 

 occurred for a year and a half — i.e. since July 1873 — although during this 

 period alone about sixty major amputations have taken place.' 



I also learn that hospital gangrene is now entirely unknown in that hospital. 

 Erysipelas likewise is extremely rare ; and, where it does appear, it is of a 



^ See Professor Volkmann on Antiseptic Osteotomy, translation in f^zw&wyg'/j Medical J ournal,M.axch. 1875. 



