292 AN ADDRESS ON THE TREATMENT OF WOUNDS 



general results obtained under circumstances so highly unfavourable would 

 afford the most conclusive proof of the value of the local treatment employed. 

 But the truth is, that the suppression of the septic element enlarges the capa- 

 bilities of surgery in the constitutional direction no less than in the local ; and 

 enables us to extend the benefits of needed operations to patients whose con- 

 stitutions are so enfeebled by age or vitiated by disease that without strict 

 antiseptic treatment no prudent surgeon would venture to meddle with them. 



I appeal to the logical faculty of this great assembly of eminent men, and 

 beg them to consider carefully in relation to this question the familiar case 

 of a simple fracture or dislocation. Do we feel anxiety regarding the state of 

 the constitution of a patient who has received such an injury ? The mischief 

 done is in itself of a worse character than the surgeon ever inflicts. Yet so 

 long as the unbroken skin shields the bruised and lacerated tissues from the 

 access of materials coming from the external world, repair advances safely, 

 no matter what be the constitutional condition ; the exceptions being so 

 extremely rare that we practically leave them out of consideration altogether. 

 It therefore surely follows that if we could contrive a treatment of our wounds 

 which would have all the advantages of the unbroken integument, we might 

 operate without anxiety on account of the constitution. 



To provide a condition of our operation-wounds that shall put them fully 

 on a par with subcutaneous injuries is plainly the ideal of our art. Towards 

 the attainment of this ideal we have already made large progress ; and towards 

 its full achievement, so far as it be possible, I would earnestly invite the best 

 efforts of my hearers. 





