470 ON THE TREATMENT OF FRACTURE OF THE PATELLA 



always when we change a dressing, invariably first to cover the wound with 

 something pure ; not to wash the surrounding parts with antiseptic solution, 

 and then, after this has been done, put a dressing on the wound ; but before 

 we begin to defile the lotion at all, put on the wound what is pure, and, last 

 thing of all, wash the surrounding parts, which, though they look the same 

 to our eyes, are different toto coelo. The edges of the dressing are septic ; the 

 wound, if it is as it ought to be, is aseptic. I have known such a thing, for 

 instance, as for a gentleman, in dressing a stump after amputation of the 

 thigh, to wash the perineum with a rag dipped in the carbolic lotion one in 

 forty ; and then, having so washed the perineum, immediately to squeeze 

 the rag over the wound. Gentlemen, that makes you laugh ; but I assure 

 you these are the kind of things that are constantly going on, and disasters 

 happen in consequence ; and gentlemen with whom things go wrong invariably 

 say that with them everything has been perfectly done — a thing which, for 

 my part, I am always loath to say. I am not likety to have many more years 

 of active surgical work ; and I have felt that when you, sir, gave me this 

 opportunity, it was my duty to speak what I believe to be the truth ; for 

 I feel it to be a grievous thing that patients should be hurried out of their 

 lives, or deprived of usefulness of limbs, simply for want of sufficient earnest- 

 ness with regard to the endeavour to obtain complete exclusion of septic 

 agencies from wounds, according to our present lights and our present know- 

 ledge. Gentlemen, I thank you most heartily for your cheers ; for there was 

 a time when such remarks might have met with a different reception. 



