AND THE HEALING ART 497 



These and many other considerations had long impressed me with the 

 greatness of the evil of putrefaction in surgery. I had done my best to mitigate 

 it by scrupulous ordinary cleanliness and the use of various deodorant lotions. 

 But to prevent it altogether appeared hopeless while we believed with Liebig 

 that its primary cause was the atmospheric oxygen which, in accordance with 

 the researches of Graham, could not fail to be perpetually diffused through 

 the porous dressings which were used to absorb the blood discharged from the 

 wound. But when Pasteur had shown that putrefaction was a fermentation 

 caused by the growth of microbes, and that these could not arise de novo in the 

 decomposable substance, the problem assumed a more hopeful aspect. H the 

 wound could be treated with some substance w^hich, without doing too serious 

 mischief to the human tissues, would kill the microbes already contained in it 

 and prevent the future access of others in the living state, putrefaction might 

 be prevented, however freely the air with its oxygen might enter. I had 

 heard of carbolic acid as having a remarkable deodorizing effect upon sewage, 

 and having obtained from my colleague, Dr. Anderson, Professor of Chemistry 

 in the University of Glasgow, a sample which he had of this product, then little 

 more than a chemical curiosity in Scotland, I determined to try it in compound 

 fractures. Applying it undiluted to the wound, with an arrangement for its 

 occasional renewal, I had the joy of seeing these formidable injuries follow the 

 same safe and tranquil course as simple fractures, in which the skin remains 

 unbroken 



At the same time we had the intense interest of observing in open wounds 

 what had previously been hidden from human view, the manner in which sub- 

 cutaneous injuries are repaired. Of special interest was the process by which 

 portions of tissue killed by the violence of the accident were disposed of, as 

 contrasted with w^hat had till then been invariably witnessed. Dead parts had 

 been always seen to be gradually separated from the living by an inflanmiatory 

 process and thrown off as sloughs. But when protected by the antiseptic 

 dressing from becoming putrid and therefore irritating, a structure deprived 

 of its life caused no disturbance in its vicinitv ; and, on the contrary, being 

 of a nutritious nature, it served as pabulum for the growing elements of the 

 neighbouring living structures, and these became in due time entirely substi- 

 tuted for it. Even dead bone was seen to be thus replaced by li\ing osseous 

 tissue. 



This suggested the idea of using threads of dead animal structures for 

 tying blood-vessels ; and this was realized by means of catgut, wtiirh i>. made 

 from the intestine of the sheep. If deprived of li\iiii; microbes, aiul otherwise 

 l)roperly prepared, catgut answers its purpose completely ; the knot holding 



