SUPPURA TION. 247 



while containing numerous saprophytic organisms, very 

 rarely contains many pathogenic bacteria. We now also 

 know that a direct stream of air, such as is generated by 

 an atomizer, causes more bacteria to be conveyed into a 

 wound than would ordinarily fall upon it, thereby in- 

 creasing instead of lessening the danger of infection. It 

 may therefore be stated, with a reasonable amount of 

 certainty, that the atmosphere is rarely an important 

 factor in the process of suppuration. 



Suppuration, while in most cases the result of micro- 

 organismal operation, is not a specific infectious process, 

 but a form of reaction that may result from a variety of 

 injurious agents. The pustules of croton oil, the ex- 

 perimental pleurisies produced by turpentine, etc., are 

 examples of the non-specific form of the process. 



Being, therefore, only the expression of violent irrita- 

 tion of the tissue, it is to be expected that as many bac- 

 teria as are capable of producing marked local damage 

 of the tissues together with chemotactic influences, may 

 be found associated with it. Very naturally some bac- 

 teria with these powers are more usual in occurrence 

 than others and will appear as the common causes of the 

 process, while every now and then some familiar organ- 

 ism that has not previously manifested phlogistic powers, 

 unexpectedly makes its appearance in pus. 



We have already called attention to the fact that vari- 

 ous micro-organisms are so intimate in their relation to 

 the skin that it is almost impossible to get rid of them, 

 and have cited in this relation the experiments of Welch, 1 

 Robb, and Ghriskey, whose method of disinfecting the 

 hands has been recommended. The investigations of 

 these observers have shown that, no matter how rigid 

 the disinfection of the patient's skin, the cleansing of 

 the operator's hands, the sterilization of the instruments, 

 and the precautions exercised, a certain number of 

 wounds in which sutures are employed will always sup- 

 purate. The cause of the suppuration is a matter of vast 



1 Amer. Jour. Med. Sciences, 1891, p. 439 



