5i6 THE THIRD HUXLEY LECTURE 



including not only those leading from the bone towards the venous trunks, 

 but also those proceeding from other parts of the limb, while the upper part 

 of the axillary was plugged with a firm adhering clot. There was also sup- 

 puration in one knee-joint and multiple abscesses in the lungs. I was struck 

 with the fact that the pus was to be found not only in the course of the 

 channels leading from the original seat of mischief to the main trunk, but also 

 in branches along which it must have advanced in the reverse direction in spite 

 of the valves of the veins. The plugging of the axillary seemed also a very 

 noteworthy circumstance. Sedillot had shown that multiple abscesses in the J 



lungs were caused by introducing pus into the veins of an animal ; and it 

 seemed probable that the collections of pus in those organs in the present 

 case had been of similar metastatic origin. Yet the plugging of the axillary, 

 shutting off the pus in the veins from the general circulation, seemed incon- 

 sistent with such a view. I took careful camera-lucida sketches of the 

 constituents of the pus from the various situations in which it occurred ; and 

 I also made a record of the magnifying power employed, by sketching with 

 the camera the scale of a micrometer placed upon the stage of the microscope. 

 And I would venture to recommend this practice strongly to pathologists. The 

 sketch which I then made is as valuable to me to-day as if it had been made 

 yesterday. I see from my drawing what I noted at the time, that the solid 

 constituents of the pus were in no case pus corpuscles such as we then knew 

 them, and I also see that they were not leucocytes. I could not explain at the 

 time the facts that I observed, but subsequent investigation has, I believe, 

 made them intelligible. 



An epidemic, as we termed it, of hospital gangrene occurred during my 

 house-surgeoncy, and I was charged with carrying out the treatment. This 

 consisted in scraping away very thoroughly under chloroform the brown 

 pultaceous slough and freely applying acid pernitrate of mercury to the exposed 

 surface. The result was, as a rule, that, when the eschar caused by the power- 

 ful caustic separated under poulticing, a perfectly healthy granulating sore 

 was disclosed which healed kindly under ordinary dressings. The only excep- 

 tion to this rule was in the case of a very stout woman, in whom the disease 

 attacked an enormous wound of the forearm caused by an accident which had 

 raised a very large flap of skin. In that case the caustic application removed 

 indeed the pain and the extensive inflammatory blush ; but when the slough 

 separated, a small brown spot was seen at one place among the otherwise 

 healthy granulations, and this spread with astonishing rapidity over the entire 

 sore. The treatment was tried again and again with the same result, till, the 

 deep structures of the limb having become seriously involved, Mr. Erichsen 



