AN ADDRESS ON CORROSIVE SUBLIMATE AS 



A SURGICAL DRESSING 



Delivered at the Opening Meeting of the ^Medical Society of London, October 20, 1884. 

 [British Medical Journal, 1884, \'ol. ii, p. 803.] 



Mr. President and Gentlemen. — When, in an address delivered at the 

 opening meeting of last session/ I expressed myself in what some of my hearers 

 regarded as terms of overweening confidence in the trustworthiness of antiseptic 

 treatment, I little thought that, a year later, I should have to tell 3'ou of failures 

 on my own part ; yet such is the case. Several instances have occurred, within 

 the last few weeks, of results deviating from our typical experience in antiseptic 

 treatment, such as I was in no wa}^ prepared to meet with, and, in one case, 

 a fatal event ensued. A lady, on whom I operated for scirrhus of the mamma, 

 with removal of the axillar\^ glands, died of a spurious pyaemia, or a variety 

 of septicaemia, an occurrence such as I have not met with for many years past. 

 We dressed the wound in the usual way. Two days after the operation, there 

 was pus already present at the anterior part of the incision. There happened 

 to have been an unusual flow of blood at this part, where we do not, as a rule, 

 expect much. It is a very unusual thing for pus to appear so early. We used 

 to say, in what I may term the pre-antiseptic da3's, that, if we operated upon 

 sound tissues, suppuration occurred, provided primary union did not take 

 place, in from three to four days, three da^'^s in children, four days in adults, 

 and, perhaps, in warm weather, rather earlier than four days. For pus to 

 occur to the amount of several drachms at the end of two da^'s was, therefore, 

 very unusual, and some special form of organism, I have no doubt, was present. 

 Micrococci were, indeed, found after death in abscesses which had formed witliin 

 the pleura. Nevertheless, though I believe some unusual organism was present, 

 we have been accustomed to consider ourselves free from the apprehension 

 of such ill effects ; and though, I am thankful to say, no other fatal case occurred, 

 there have been several instances of deviation from the typical course, where, 

 instead of union without suppuration at all, we have had healing retarded by 

 the formation of more or less pus, undoubtedly of a septic character, in the 

 sense in which we now use the term septic, that is to say, dependent upon the 

 development of micro-organisms, althougli no smell was ]XMTeptible. Now, 

 sir, I need hardly say that one such result as that to which 1 liave referred, 



' See p. 45 ; of this volume. 



