34 



LECTURE II. 



SEPSIS AND ANTISEPTIC SURGERY. 



THE infectious diseases usually consequent upon wounds, 

 and therefore falling within the province of the sur- 

 geon, merit somewhat extended discussion. Such dis- 

 eases were known to the earliest medical writers, and, 

 we may assume, antedate man himself by so much time 

 as the existence of highly organized life preceded him. 

 Clinical experience had, long before the advent of ex- 

 perimental research, identified infectious septic material 

 with the products of that complicated process whereby 

 lifeless organic substances are de- and re-composed into 

 chemically less complex matters putrefaction ; and 

 early experimental investigation was directed to the elu- 

 cidation of that process and its relations to disease. 

 Gaspard first proved experimentally that the injection of 

 putrefying substances of animal or vegetable origin 

 blood, pus, bile was followed by the clinical features of 

 sepsis. Panum demonstrated that the putrid infectious 

 substance is not gaseous ; that it is not destroyed by eleven 

 hours' boiling and complete desiccation ; that it is insol- 

 uble in alcohol, but present in the watery extract of pu- 

 trid materials, even when dried ; that the albuminous 

 matters in putrid fluids are not per se septic,, but con- 

 dense the infectious matter upon their surfaces ; for the 

 filtrate, containing no solid particles, preserves the septic 

 properties unimpaired. Panum concluded that the pu- 

 trid agent must be a definite chemical compound like 

 curare and the alkaloids, and named this hypothetical 

 substance sepsin. Billroth, Weber, Hemrner, and Schwen- 

 inger repeated and confirmed these experiments. The 

 last-named observer concluded from the fact that different 

 results followed the administration of the same quantity 

 of the same putrid liquid at different stages of putrefac- 



