Page:Popular Science Monthly Volume 81.djvu/20

14 pyemia, between the bacteria of the local lesion and those in the internal organs, and had observed bacteria within the leucocyte. To us, who view these activities in retrospect, they are phases of a general advance, the culmination of which is common knowledge, but in the early seventies they were merely the non-related efforts of individual workers. Some practical demonstration was necessary to give to the newer type of laboratory work an importance which would impress the profession. Such a demonstration came through Lister's antiseptic treatment of wounds and was followed shortly by the observations of Koch on anthrax, and of Pasteur on vaccination against bacterial disease.

Lister's first publication concerning his treatment of wounds was in 1867, but it was not until the late seventies that his views were quite generally accepted. In the meantime his methods and their results served to concentrate attention on bacteria and their relation to the diseases of man. He regarded wound infection as putrefaction due to the invasion of the wound by minute microorganisms of the air; a conception which, as he acknowledges in his first publication, was suggested by Pasteur's work on fermentation. In a letter to Pasteur in 1874 he offers "most cordial thanks for having demonstrated to me the germ theory of putrefaction, and thus furnished me with the principle upon which alone the antiseptic treatment can be carried out."

His method was to combat this air-borne infection with an antiseptic—carbolic acid. He cleaned a wound by wiping it out with carbolic acid and then sealed it with lint soaked in this acid. All instruments, sponges and dressings coming in contact with the wound or the hands of the operator or assistants, as well as the site of operation, were cleansed in the same way. Also, by means of a vaporizer, carbolic acid was sprayed into the atmosphere about the site of operation. As years passed the details of this method changed. We now speak of the suppuration of wounds, not of putrefaction; the carbolic spray has been abandoned and our ideas about sepsis have been modified in several ways, but the principle remains as Lister conceived it. The beneficial results of this new treatment in Lister's hands were immediate, but its general application came slowly. We find Pasteur in 1874 referring to Lister's "marvellous surgical methods" and recommending to the surgeons of Paris the use of instruments and dressings sterilized by heat. The complete acceptance of Lister's principle would appear to correspond to the year 1883, when he was made a baronet.

The benefits of antisepsis are now so familiar to us, and its use so much a matter of routine, that we cease to wonder at the revolution it brought about in surgery. Some diseases, as hospital gangrene, it has abolished entirely; others as the septic surgical diseases of former days have been reduced almost to nil; it has robbed the period of child-bearing of one of its chief perils, and has opened to surgery regions and