UPON THE GENERAL SALUBRITY OF SURGICAL HOSPITALS 251 



superficial and mild type ; and Professor Volkmann told me that his experience 

 of the effects of antiseptic treatment in diminishing the amount and severity 

 of that disease was so striking, that he entirely differed from the opinion of 

 Professor Thiersch on this matter.^ 



Amongst the cases brought before us in Professor Volkmann's demonstration 

 was one of excision of the hip-joint, where putrid sinuses had existed before the 

 operation. About a week had passed since the operative procedure, but there 

 was no purulent discharge whatever ; and no fluid even of a serous character 

 could be pressed out from the small spot that alone remained unhealed, and the 

 use of a drainage-tube had been already given up. In short, the case had 

 followed the typical course we expect under antiseptic treatment when we 

 operate with an unbroken skin. This is a kind of result I myself had never 

 yet obtained, and it filled me with astonishment. I inquired how it had been 

 arrived at, and I found it was as follows. Professor Volkmann several years 

 ago strongly advocated the application to diseased soft parts of ' the sharp 

 spoon ' which had been introduced into German surgery by Bruns, of Tubingen, 

 for scraping carious bone. Thus, supposing a strumous abscess to be opened, 

 instead of leaving the degenerated textures around to come away by a tedious 

 process of suppuration, or to be removed by slow absorption, he scraped it all out 

 at once with the sharp spoon, and thus greatly accelerated the recovery. Being 

 thus accustomed to the use of this instrument, he applied it to clear out the 

 pyogenic membrane of putrid abscesses and sinuses, and all granulations around 

 the diseased bones after excision. For my part, I have always, after operating 

 upon such a case, treated the cut surfaces with solution of chloride of zinc, and 

 injected the sinuses with the same, in the faint hope of exterminating existing 

 putrefaction ; but I have practically never succeeded. The failure was always 

 readily intelligible to me, on the ground that I could never get the antiseptic 

 to penetrate all the recesses of the sinuses and the lymph or sloughs lying among 

 the granulations. But here Professor Volkmann had cleared out the offending 

 substances altogether, and then introduced an antiseptic lotion ; and he told 

 me, to my amazement, that it was the rule with him to attain results of the 

 character I then witnessed. If my journey on the Continent had been one 

 of unmixed labour, I should have thought that labour well rewarded b\- this 

 circumstance in my visit to Halle. I have alread3^ put this plan in operation 

 in my own practice since my return, and I hope to show you some of the results 

 to-morrow, at a demonstration in the operating-theatre of the Royal Inlirmary. 

 Whether I can obtain such frequent success as Professor Volkmann, I do not 

 know ; but I have already succeeded in some cases. 



' See note at the foot of page J49. 



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