418 



SCIENCE. 



[N. S. Vol. IV. No. 91. 



stration of the liarmlessness of the atmos- 

 pheric dust in surgical operations. This 

 conclusion has been justified by subsequent 

 experience ; the irritation of the wound by 

 antiseptic irrigation and washing may 

 therefore now be avoided, and nature left 

 quite undisturbed to carry out her best 

 methods of repair, while the surgeon may 

 conduct his operations as simply as in 

 former days, provided always that, deeply 

 impressed with the tremendous importance 

 of his object, and inspiring the same con- 

 viction in all his assistants, he vigilantly 

 maintains from first to last, with care that, 

 once learnt, becomes instinctive, but for 

 the want of which nothing else can com- 

 pensate, the use of the simple means which 

 will suffice to exclude from the wound the 

 coarser forms of septic impurity. 



Even our earlier and ruder methods of 

 carrying out the antiseptic principle soon 

 produced a wonderful change in my surgi- 

 cal wards in the Glasgow Eoyal Infirmary, 

 which, from being some of the most un- 

 healthy in the kingdom, became, as I be- 

 lieve I may say without exaggeration, the 

 healthiest in the world ; while other wards, 

 separated from mine only by a passage a 

 few feet broad, where former modes of 

 treatment were for a while continued, re- 

 tained their former insalubrity. This result, 

 I need hardly remark, was not in any de- 

 gree due to special skill on my part, but 

 simply to the strenuous endeavor to carry 

 out strictly what seemed to me a principle 

 of supreme importance. 



Equally striking changes were afterwards 

 witnessed in other institutions. Of these 

 I may give one example. In the great All- 

 gemeines Krankenhaus, of Munich, hospital 

 gangrene had become more and more rife 

 from year to year, till at length the fright- 

 ful condition was reached that 80 per cent, 

 of all wounds became affected by it. It is 

 only just to the memory of Prof, von Nuss- 

 baum, then the head of that establishment, 



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 man- 

 agement was shown by the fact that in a 

 private hospital under his care there was no 

 unusual unheal thiness. The larger institu- 

 tion seemed to have become hopelessly 

 infected, and the city authorities were con- 

 templating its demolition and reconstruc- 

 tion. Under these circumstances, Prof von 

 Nussbaum dispatched his chief assistant. 

 Dr. Lindpaintner, to Edinburgh, where I at 

 that time occupied the chair of clinical 

 surgery, to learn the details of the anti- 

 septic system as we then practiced 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 Kranken- 

 haus. The fearful disease pysema likewise 

 disappeared, and erysipelas soon followed 

 its example. 



But it was by no means only in removing 

 the unhealthiness of hospitals that the anti- 

 septic system showed its benefits. Inflam- 

 mation being suppressed, with attendant 

 pain, fever and wasting discharge, the suf- 

 ferings of the patient were, of course, im- 

 mensely lessened ; rapid primary union 

 being now the rule, convalescence was cor- 

 respondingly 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. 



It pleases me to think that there is an 

 ever-increasing number of practitioners 

 throughout the world to whom this will not 

 appear the language of exaggeration. There 

 are cases in which, from the situation of 



