Further, I have found that when the antiseptic treatment is
efficiently conducted, ligatures may be safely cut short and left
to be disposed of by absorption or otherwise. Should this
particular branch of the subject yield all that it promises,
should it turn out on further trial that when the knot is applied
on the antiseptic principle, we may calculate as securely as if
it were absent on the occurrence of healing without any deep-
seated suppuration, the deligation of main arteries in their
continuity will be deprived of the two dangers that now attend
it, viz., those of secondary haemorrhage and an unhealthy state
of the wound. Further, it seems not unlikely that the present
objection to tying an artery in the immediate vicinity of a large
branch may be done away with; and that even the innominate, which
has lately been the subject of an ingenious experiment by one of
the Dublin surgeons, on account of its well-known fatality under
the ligature for secondary haemorrhage, may cease to have this
unhappy character when the tissues in the vicinity of the thread,
instead of becoming softened through the influence of an
irritating decomposing substance, are left at liberty to
consolidate firmly near an unoffending though foreign body.
It would carry me far beyond the limited time which, by the rules
of the Association, is alone at my disposal, were I to enter into
the various applications of the antiseptic principle in the
several special departments of surgery.
There is, however, one point more that I cannot but advert to,
viz., the influence of this mode of treatment upon the general
healthiness of an hospital. Previously to its introduction the
two large wards in which most of my cases of accident and of
operation are treated were among the unhealthiest in the whole
surgical division of the Glasgow Royal Infirmary, in consequence
apparently of those wards being unfavorably placed with reference
to the supply of fresh air; and I have felt ashamed when
recording the results of my practice, to have so often to allude
to hospital gangrene or pyaemia. It was interesting, though
melancholy, to observe that whenever all or nearly all the beds
contained cases with open sores, these grievous complications
were pretty sure to show themselves; so that I came to welcome
simple fractures, though in themselves of little interest either
for myself or the students, because their presence diminished the
proportion of open sores among the patients. But since the
antiseptic treatment has been brought into full operation, and
wounds and abscesses no longer poison the atmosphere with putrid
exhalations, my wards, though in other respects under precisely
the same circumstances as before, have completely changed their
character; so that during the last nine months not a single
instance of pysemia, hospital gangrene, or erysipelas has
occurred in them.
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