264 DEMONSTRATIONS OF ANTISEPTIC SURGERY BEFORE 



spray passes into the angle between it and the skin. And now, Gentlemen, 

 I venture to say here is a novelty for such of you as have not practised antiseptic 

 surgery. There is the blood-clot still lying in the widely gaping wound, pur- 

 posely kept open by this drainage-tube, which I introduced down to the open 

 joint when I made the incision fifteen days ago, and which has never yet been 

 taken out. 



I have not seen this wound myself since I made it. I am sometimes accused 

 of taking a deal of unnecessary pains with my cases, and it is also said that 

 any good results which I may get are due to my own personal care. If such 

 were the case. Gentlemen, if I obtained better results than other surgeons by 

 the more careful use of the same means, that would indeed be something to be 

 proud of. But it is not so. It is simply that we are working on a new principle. 

 Mr. Rice, my house surgeon, who was trained first as a dresser and afterwards 

 as a clerk under me, does these things exactly as I do them myself. If I were 

 to go away for a week, a fortnight, or a month, as far as the antiseptic element 

 is concerned, I should feel I had left my patients in perfectly safe hands. In 

 this particular instance, Mr. Rice has had sole charge of the dressing after the 

 first day, and here is the result. I am very glad to see, looking at the foot 

 now for the first time for a fortnight, that the inflammatory thickening has 

 almost entirely gone. I had of course made inquiry as to the patient's progress, 

 and I had learned from his lips that the pain was greatly diminished, as the 

 immediate result of the incision. I used to have a great horror of opening 

 into the tarsal articulations in cases of this sort in consequence of the disastrous 

 results which I have known to occur, through the spreading of suppuration 

 among them. But if the skin is unbroken, so that the antiseptic system can 

 be brought fairly into operation, there is no such danger. Here there has not 

 only been no disturbance whatever from the operation, but we have obtained 

 the benefit that we anticipated from free incision. The inflammation which 

 previously existed has almost, if not entirely, disappeared. 



And now let me direct your attention again to this remarkable appearance 

 of the blood-clot lying in the open wound fifteen days old. If we had not used 

 antiseptic means, that would have been impossible. Some people say, We can 

 show you good results without antiseptic treatment. Of course, good results 

 can be got by good surgery without antiseptic treatment ; but I say this is an 

 instance of something that could not possibly happen without it. When a 

 blood-clot existed in an open wound under a moist dressing which was not 

 antiseptic, it was absolutely certain to putrefy and disappear long before the 

 lapse of fifteen days. Let us now see what change may have taken place in 

 this clot. I see, when I raise the upper layer of it from the edge of the wounds 



