The Democratic advocate. [volume] (Westminster, Md.) 1865-1972, 1889-10-19
Our 9liO.
Wonders OF Surgery.

Dr. ". W Keen OF pbBaIelhia Pa in HarPcr's
Magazine
In no department Of medicine has there
been more rapid, and in many respects
more astonishing progress in recent years
than in surgery This progress Is due
chiefly o. two thin-s-the introduction Of
autisep,ic methods, and to what We have
learned from laboratory work aud expert
meuts upon animals Ii has long been
known that simple fracture, in which
the skin is unhrokou and compound
fracture in which the skin Is broken.
aud the air has easy access 10 the trac-
sured bone, were vastly different in
their dangers, but why the communi-
cation With the air was 80 dangerous
was o mystery OF late years, however,
the germs existing in the atmosphere, and
on every material coming into contact with
the wound such as dirty clothing 0rdinari-
Is clean Instruments, the skin Of the patti
ent, the hands OF the surgeon and the dress
iugs have been investigated By a large
number Of Observers, and !, has been abun-
dainty proved that infection comes not
FROM the wound per 80, but from the OK
terror. and that this infection from without
l. the cause Of inflammation aud Of ITS
speedy sequel the formation Of "pus that
i. matter j Once that pus begins 10
form fever. Assesses, blood poisoning,
gangrcne. crysipclas, one or all. may start
up into ominous and fatal activity. In
aammati0n and suppuratiun that : the
formation OF pus then, are the causes Of
al these evil processes. They are all cali
cd briefly -septic" that is poisonous ,
proeess,7- Hence 'an,iseptic methods
an those that prevent Inflammation and
suppura,ion.
Now We see why compound fracture
or any other open wound that Is, one
in which the protective defence OF the skin
i destroyed, Is - much more dangerous
than simple fracture or subeutaneous
wound. Il arises from the fact that these
septic germs, or microbes, have easy
acegzs 70 the tissues, and once there, mul-
,iply with almost incredible rApidi,y.
Professor Cradle estimates that siu-
gle nierobe 50 small that forty billions
would weigh less than q grain, IT !, have
amplc room aud abundant food, viii in-
crease So rapidly that in twenty four hours
there would be 6fieeu millions Of them,
and in three days they would form mass
weighing SO0 tons
These quick u set up inflammation and
sappuration and their consequences. Al
first it was thought that the chief danger
lay in atmospheric germs, but later investl-
-a,icns have proved that the skin Of the
patient, aud especially the hands Of the
surgeon, and his instruments and spongcs,
and even his dressings, are far more IRE
qgent sources Of infection.
Perhaps | cannot better illustrate the
difference between the old. or septic,
and the new, or "antiseptic, surgery than
by describing two amputations, one such as
was commonly done for instance, during
the late war, aud the other such as Is done
now by every good surgeon. Ii faci, 1t Is
enly within the last ten or fifteen years
that an,iseptic surgery has become general
lied in the profession.
THE OH WAY.
Let Us suppose an amputation above the
elbow. and the operator the best surgeon
of the late war The arm was not specially
prepared, except that it would be cleaned
Of is coarse dirt arising from the accident,
but that would be ALL The instruments
We're taken ont Of an ordinary case and
placed on a table, aud during the operation
we're frequently placed upon the patients
clothing, soiled often by the accident neces-
stating the operation, as well as by more
or less wearing. If the instruments OF
Sponges fell upon the floor, they would be
picked up, dipped into water, aud then
used with innocent equauimity. The
spouges, washed aud dried from the last
operation. were simply thrown into basin
of ordinary water The hands of the sur
seon were as clean as gentleman would
always keep his hands The amputation
having been done, the arteries were tied
with silk threads (ealled ''ligatures }, one
end Of each being left long. The ends
were left hanging out of the wound at any
convenient place, and in an amputation of
a muscular thigh might number a score or
more. Hemorrhage having been checked,
the two flaps were sewed together with
wire or silk threads, called "sutures. In
threading the needle, the thread would
often be shaped into a point by the lips, or
after being wetted with septic saliva, would
be rolled between septic fingers. \ piece
of lint, or often a piece of soft old linen
rag. spread with some grease, was placed
upon the stump, and suitable baudage
applied The next day the dressings were
removed, and the wound was redressed in
similar manner At the end of n or IS
hours fever would set in, called, in our
text books, surgical fever, thus assum-
ing that surgical operation always result
ed in such Il fever; nor was the assumption
erroneous This would continue for several
days, the temperature ranging from 1922
to 104 or 1862 f. In few days, when
suppuration became established (and this
was almost always expected by the surgeon, },
the fever would gradually subside, and
later the suppuration also would diminish.
At the end of week or ten days the sur
geon would pull gently on each silk liga-
] ture. to see if it had rotted loose from the