CALCUTTA MEDICAL INSTITUTIONS. 7
and their consequences, of which it is sufficient to say here that they are entirely
satisfactory, and that nothing occurred during the year which could suggest
a thought of preventable mortality. Dr. McLeod, the first surgeon, thinks
that a misapprehension has arisen as to the teaching, by him, of a system
which his pupils will find impracticable in private life. He now writes : "What
I do teach and practice is not the Listerian method, but the Listerian principle
of asepsis and its advantages. I have not in one single case, since I became First
Surgeon, carried out the Listerian method in all its details
* *
it is only in large and delicate operations that I resort to some of the more
complicated Listerian materials and methods. I have found that students are
able intelligently and effectively to follow even the more complicated plans of
dressing in private practice ; and as regards the simpler, I cannot conceive
anything less difficult or expensive, except the open system which I also teach
and illustrate, than that which I employ in most cases. I trust, therefore, that
the surgeon-general and Government will be pleased to cancel the censure
which the sentences which I have quoted might be understood to imply."
The reference here is to the words of the resolution on the report for 1882,
paragraph 6: "Dr. McLeod, in the first ward, carried out the Listerian method
in its entirety ;" and paragraph 7: "The advantage of strict Listerism seems
doubtful in hospital practice ; while, as a system to be taught exclusively to
pupils, it is not desirable."
14.
I
am sure that the Lieutenant-Governor, in producing these words
from my report, had no more intention of implying censure than I had in
writing them. It was intended merely to point out that the public usefulness of
a method depends on other considerations besides its efficacy. It would seem
that there is some distinction to be drawn between "strict Listerism—" "Lister's
method in all its details—" "and a strict antiseptic method." Into this I can-
-not enter, but no one, I think, could have read Dr. McLeod's previous writings,
and the terms in which he declared that he practised strict Listerism without
supposing that he practised the Listerian method in its entirety whenever he
could ; and regretted it when he could not. Appended to the annual report
for 1880 there is a special report by Dr. McLeod, on this subject He writes
(paragraph 4) concerning his earlier experience in 1874-75: "I practised what I
thought was antiseptic surgery, and was grievously disappointed with the result.
It was not until I went to Edinburgh in 1876 and followed Professor Lister
in his wards that I became aware that what I had been doing was not in full
accord with his tenets and teaching, and that a "modified antiseptic" system
is a delusion"; again (paragraph 5) "not one of the cases in which I have
succeeded in carrying out strict Listerism since I rejoined the hospital in April
1879 has manifested any sign or form of septic infection
*
*
*
*
* In the treatment of the other cases "Listerism"
for various reasons could not be established." Again, paragraph 8, "I have
endeavoured to treat these cases during the past six months in accordance with
strict Listerism." Again, paragraph 10, "on that account I teach and practise
in every surgical case which I treat as close an approach to absolute Listerism,
which may be called the perfection of surgical cleanliness, as possible."
Throughout Dr. McLeod has come forward as the advocate of "strict Listerism,"
affirming its value and the economy of it under that name, whenever occasion
has arisen, with all the distinctive force of the words. Now, however, it seems,
"strict Listerism" does not embrace the "Listerian method in all its details;"
for this, says Dr. McLeod, "I have not, in one single case, since I became
first surgeon, carried out."
The Lieutenant-Governor will not be able to form, from the above, a very
exact idea of the teaching and practice adopted, but will probably pronounce
it sufficient that practical results have been good, and that attention has been
drawn to prospective utility in teaching.
15. Mortality after operation at the Campbell hospital attracted attention
in former years. It has of late years been small, and in 1883 was smaller
than ever. There is no doubt that the surgical practice of this hospital has
greatly improved in many respects, and it is interesting to note that good
results are accomplished with moderate use of antiseptics.