57 '&- 



plished theoretically in any one of three ways : i, the 

 exclusion of putrefiable materials, i.e., cleanliness; 2, the 

 exclusion of bacteria ; 3, the addition of a substance in 

 whose presence putrefactive bacteria are inert. 



It is evident that the accomplishment of any one of 

 these three ends is antiseptic, or, if you prefer on ety- 

 mological grounds, aseptic surgery. There is a preva- 

 lent inclination to consider Listerism and antiseptic 

 surgery as synonymous terms ; and to regard the success 

 in avoiding sepsis which is secured by other methods 

 the open air and simple water dressing, for example 

 as proof not only that the Listerian details are unneces- 

 sary, but also that the agency of bacteria in the induction 

 of sepsis an agency which the Lister method was de- 

 vised to defeat is a myth, a mere craze, a fashion. It 

 is manifest, however, that antiseptic surgery is far more 

 comprehensive than Listerism. Listerism aims chiefly at 

 but one of the three possible ways for the prevention 

 of sepsis the exclusion of ferments ; the very methods 

 whose success has been considered proof of the fallacy 

 of antiseptic surgery demonstrate practically what is 

 self-evident theoretically, that putrefaction and putrid 

 infection from a wound can be prevented by the removal 

 of putrefiable materials, just as certainly as by the ex- 

 clusion of organisms. The aseptic success of Savory 

 and Lawson Tait rivalling that of Volkmann, Esmarch, 

 and Lister, was secured by the most scrupulous care in 

 avoiding the retention or accumulation of any discharge 

 in the wound. The result is asepsis, the means aseptic. 



That this method of preventing sepsis affords the same 

 certainty of success and possesses the same range of ap- 

 plicability as the Listerian, I would not maintain ; in- 

 deed, my own limited experience, including some obser- 

 vation of surgery in St. Bartholomew's Hospital, inclines 

 me to the contrary belief. I would merely protest 

 against the not infrequent assertion that Savory's and 

 Tait's success in avoiding putrid infection is an argument 

 against the demonstrated agency of bacteria in the in- 

 duction of sepsis. 



3* 



