59 



had, even in Billroth's skilful hands, been followed by a 

 greater mortality than that attending ovariotomy, was de- 

 prived of its septic terrors. I would particularly recom- 

 mend this to the consideration of those who ignore all 

 experimental work, who admit as worthy of considera- 

 tion only clinical results, and who regard the success of 

 Savory and Tait as the overthrow of aseptic surgery in 

 particular, and of bacteria in general. Here is aseptic 

 surgery par excellence, though the spray, protective, 

 mackintosh, and attendant paraphernalia are absent ; 

 here is the prevention of septic infection by measures 

 which do not exclude bacteria from the wound, but sim- 

 ply restrain their development. The method of Lister, 

 conceived and devised upon a hypothesis, before the as- 

 sumptions of that hypothesis had been verified, con- 

 tained, as subsequent developments demonstrated, some 

 errors of conception and execution. The spray, for 

 example, that sign-manual of Listerism in the pro- 

 fessional mind, seems less essential since we have 

 learned that bacteria are less numerous in the atmos- 

 phere than was formerly supposed ; and when we con- 

 sider the researches published by the German Health 

 Bureau, it seems somewhat doubtful whether the carbolic 

 acid spray ever killed a single healthy bacterium ; the 

 vitality of certain spores is certainly not thereby affected. 

 Koch found that the spores of anthrax bacilli, for exam- 

 ple, retained their power of development after immersion 

 for seven days in a two per cent., and after twenty-four 

 hours in a five per cent, solution of carbolic acid ; yet 

 the bacilli lost their vitality after two minutes' contact 

 with even a one per cent, solution. The clinical results 

 also support the assertion that irrigation of the wound 

 accomplishes quite as effectually the object for which the 

 spray was designed. Yet it must be admitted that ex- 

 cept in those cases, such as abdominal sections, where 

 the spray causes positive and decided injury, there is a 

 possibility of benefit from its use. 



For application to the wound, many substitutes have 

 been proposed for the objectionable carbolic acid ; 



