56 



bolized ; but the patient's skin was not even washed ; 

 several coils of intestine were in course of the operation 

 laid upon the skin, and came in contact with the pubic 

 hair. The operation itself was not formidable, but the 

 woman died of purulent peritonitis. 



If no infectious matter be thus carelessly introduced 

 from without, the occurrence of sepsis from a wound 

 necessarily implies decomposition in the wound itself. 

 For the accomplishment of such decomposition it is evi- 

 dent that three factors must concur : i, the presence of 

 animal tissues deprived of vitality, and hence capable 

 of putrefaction ; 2, the presence of organisms capable of 

 inducing putrefaction ; 3, the prevalence of conditions 

 which permit the vital activity of these organisms. The 

 absence of any one of these conditions renders putrid 

 infection impossible. We are familiar with analogous 

 phenomena outside of the body. Urine or blood in free 

 contact with ordinary air putrefies ; if access of bacteria 

 be prevented by closing the mouth of the test-tube with 

 cotton, etc., putrefaction does not occur ; the process 

 can be prevented with equal certainty by changing the 

 environment addition of alcohol for example whereby 

 the vital activity of bacteria is arrested. We have abun- 

 dant evidence, as has been already stated, that the same 

 principles prevail within as well as without the living 

 animal. That the bacteria ordinarily present in the air 

 are powerless to destroy living tissues is proven by the 

 fact that un filtered ordinary air has been passed for hours 

 through the peritoneal cavity of rabbits without inducing 

 pathological changes indeed, the entire subcutaneous 

 tissue of animals has been inflated with air with like re- 

 sult ; by the harmlessness of surgical emphysema ; by 

 Miller's injection of such bacteria into his own body, etc. 

 That the presence of putrefiable substances, if excluded 

 from these same bacteria, gives rise to no putrefaction nor 

 sepsis is shown in the cases of intra- and extra-uterine pre- 

 gnancy, where a dead foetus is carried for months or years. 



The prevention of decomposition and consequent 

 septic infection from a wound can therefore be accom- 



