BEFORE AND AFTER LISTER 159 



You look upon limbs variously wounded, but all of 

 them lying out, swollen, suppurating, fistulous, rotting 

 in their own filth, having carious bones, bleeding 

 arteries and a profusion of matter; the patients ex- 

 hausted in the meanwhile, with diarrhea, fever and 

 pain. 



Again he refers to a wounded limb as "soaking in sup- 

 puration" and again, of its "lying in a slush of matter 

 and foul poultices." 



He relates the case of an officer under the care of 

 Guerin, a celebrated French surgeon. He was wounded 

 by a ball which had broken the fifth rib twice and tra- 

 versed the entire chest. After dilating the wounds, Guerin 

 introduced a seton ["a great strap of coarse linen"], 



which, of course, went across the breast as a bow- 

 string crosses a bow, and this seton he continued to 

 draw with a perseverance which is truly wonderful 

 from the first day to the thirty-eighth day of the 

 wound ; during all of which time the patient's suffer- 

 ings were dreadful (p. 458). 



In fifteen days the patient was bled twenty-six times. 

 After the removal on the thirty-third day of a splinter 

 of bone, which had been imbedded in the lung, the pa- 

 tient, strange to say, recovered both from the wound and 

 from the surgeon. It is not to be wondered at that Bell 

 condemns such treatment. But, as we have seen, it ex- 

 isted in the practice of reputable surgeons. 



Erysipelas, tetanus, pyemia, septicemia were rife. Hos- 

 pital gangrene was endemic in many if not most hospitals, 

 due to inevitable infection in practically every wound. 

 Veritable epidemics were frequent. Is it any wonder 

 that it had always been present for nearly two hundred 

 years in the Hotel Dieu in Paris when there were often 

 from two to six patients (and such patients!) in one 

 bed ? Passing along the streets of Paris even during the 



