ON SOME POINTS IN THE HISTORY OF 

 ANTISEPTIC SURGERY 



[Lancet, 1908, vol. i, p. 1815 ; and British Medical Journal, 1908, vol. i, p. 15 ;7.] 



[The following unfinished letter to Sir Hector Cameron was written early in icyo6, before the deUvery 

 of his Lectures on the Evolution of Wound Treatment, but never sent to him. I have been assured that 

 it would have sufficient interest for some readers to warrant its publication.] 



My dear Cameron. — It seems superfluous for me to write anything to you 

 with reference to your coming lectures.^ But perhaps in what I shall say, there 

 may be here and there points which may interest you. 



In treating surgical cases antiseptically, I always endeavoured to avoid 

 the direct action of the antiseptic substance upon the tissues, so far as was 

 consistent in the existing state of knowledge with attaining the essential object 

 of preventing the development of injurious microbes in the part concerned. 



In compound fracture, to which in 1865, I first put in practice the antiseptic 

 principle, I applied undiluted carbolic acid freely to the injured part, in order 

 to destroy the septic microbes already present in it ; regarding the caustic action 

 which I knew must occur as a matter of small moment compared with the 

 tremendous evil which it was sought to avoid. But when this had once been 

 done, no further direct action of the antiseptic upon the tissues occurred. The 

 carbolic acid formed with the blood a dense chemical compound which, together 

 with some layers of lint steeped in the acid, produced a crust that adhered 

 firmly to the wound and the adjacent part of the skin. This crust was left 

 in place till all danger was over, its surface being painted from time to time 

 with the acid, to guard against the penetration of septic change into its sub- 

 stance. Meanwhile, in the undisturbed wound the beautiful result occurred 

 that the material of the crust within it, and the portions of tissue which had been 

 destroyed by the caustic, were replaced by living tissue formed at their expense. 



That dead tissue, when protected from external influences, was so disposed 

 of, was a most important truth new to pathology ; and it afterwards suggested 

 the idea of the catgut ligature. 



' 'The Dr. J.uuls Walsun l.Lcturcs delivered at the Faculty of Physicians and Surgeons oi Glasgow 

 in February, 1906.' Glasgow 1907. 



