AND THE HEALING ART 501 



with attendant pain, fever, and wasting discharge, the sufferings of the patient 

 were, of course, immensely lessened ; rapid primary union being now the rule, 

 convalescence was correspondingly curtailed ; while as regards safety and the 

 essential nature of the mode of repair, it became a matter of indifference whether 

 the wound had clean-cut surfaces which could be closely approximated, or 

 whether the injury inflicted had been such as to cause destruction of tissue. 

 And operations which had been regarded from time immemorial as unjustifi- 

 able were adopted with complete safety. 



It pleases me to think that there is an ever-increasing number of prac- 

 titioners throughout the world to whom this will not appear the language of 

 exaggeration. There are cases in which, from the situation of the part concerned 

 or other unusual circumstances, it is impossible to carry out the antiseptic system 

 completely. These, however, are quite exceptional ; and even in them much 

 has been done to mitigate the evil which cannot be altogether avoided. 



I ask your indulgence if I have seemed to dwell too long upon matters in 

 which I have been personally concerned. I now gladly return to the labours 

 of others. 



The striking results of the application of the germ theory to surgery acted 

 as a powerful stimulus to the investigation of the nature of the micro-organisms 

 concerned ; and it soon appeared that putrefaction was by no means the only 

 evil of microbic origin to which wounds were liable. I had myself very early 

 noticed that hospital gangrene was not necessarily attended by any unpleasant 

 odour ; and I afterwards made a similar observation regarding the matter formed 

 in a remarkable epidemic of erysipelas in Edinburgh obviously of infective 

 character. I had also seen a careless dressing followed by the occurrence of 

 suppuration without putrefaction. And as these non-putrefactive disorders 

 had the same self-propagating property as ferments, and were suppressed by 

 the same antiseptic agencies which were used for combating the putrefactive 

 microbes, I did not doubt that they were of an analogous origin ; and I ventured 

 to express the view that, just as the various fermentations had each its special 

 microbe, so it might be with the various complications of wounds. This surmise 

 was afterwards amply verified. Professor Ogston, of Aberdeen, was an early 

 worker in this field, and showed that in acute abscesses, that is to say those 

 which run a rapid course, the matter, although often quite free from unpleasant 

 odour, invariably contains micro-organisms belonging to the group which, from 

 the spherical form of their elements, are termed micrococci ; and these he classed 

 as streptococci or staphylococci, according as they were arranged in chains or 

 disposed in irregular clusters like bunches of grapes. The German pathologist, 

 Fehleisen, followed with a beautiful research, b}' which he clearly proved that 



