14 REPORT—1896. 
to the strenuous endeavour to carry out strictly what seemed to me a prin- 
ciple of supreme importance. 
Equally striking changes were afterwards witnessed in other institu- 
tions. Of these I may give one example. In the great Allgemeines 
Krankenhaus of Munich, hospital gangrene had become more and more 
rife from year to year, till at length the frightful condition was reached 
that 80 per cent. of all wounds became affected by it. It is only just to 
the memory of Professor von Nussbaum, then the head of that establish- 
ment, to say that he had done his utmost to check this frightful scourge ; 
and that the evil was not caused by anything peculiar in his management 
was shown by the fact that in a private hospital under his care there was 
no unusual unhealthiness. The larger institution seemed to have become 
‘hopelessly infected, and the city authorities were contemplating its demo- 
lition and reconstruction. Under these circumstances, Professor von 
Nussbaum despatched his chief assistant, Dr. Lindpaintner, to Edinburgh, 
where I at that time occupied the chair of clinical surgery, to learn the 
details of the antiseptic system as we then practised it. He remained 
until he had entirely mastered them, and after his return all the cases 
were on a certain day dressed on our plan. From that day forward not 
a single case of hospital gangrene occurred in the Krankenhaus. The 
fearful disease pyzemia likewise disappeared, and erysipelas soon followed 
its example. 
But it was by no means only in removing the unhealthiness of hos- 
pitals that the antiseptic system showed its benefits. Inflammation being 
suppressed, with attendant pain, fever, and wasting discharge, the suffer- 
ings of the patient were, of course, immensely lessened ; rapid primary 
union being now the rule, convalescence was correspondingly curtailed ; 
while as regards safety and the essential nature of the mode of repair, it 
became a matter of indifference whether the wound had clean-cut surfaces 
which could be closely approximated, or whether the injury inflicted had 
been such as to cause destruction of tissue. And operations which had 
been regarded from time immemorial as unjustifiable were adopted with 
complete safety. 
Tt pleases me to think that there is an ever-increasing number of prac- 
titioners throughout the world to whom this will not appear the language 
of exaggeration. There are cases in which, from the situation of the part 
concerned or other unusual circumstances, it is impossible to carry out the 
antiseptic system completely. These, however, are quite exceptional; and 
even in them much has been done to mitigate the evil which cannot be 
altogether avoided. 
I ask your indulgence if I have seemed to dwell too long upon matters 
in which I have been personally concerned. I now gladly return to the 
labours of others. 
The striking results of the application of the germ theory to Surgery 
acted as a powerful stimulus to the investigation of the nature of the 
