Professional Notes

THE HOSPITAL. Nov. 12, 1887. 113 the pus, and the patient will die ; remove the pus and the Professional Notes. patient may recover. It was clearly, therefore, the duty of By Gbo. W. Potter, M.D. the surgeon to operate ; as it would have been the duty of a general practitioner in similar circumstances if no medical men some wlio do had been at how few There are still to be found among operating surgeon hand. But not believe in what is called the "antiseptic treatment." general practitioners would have operated I We call atten- Among intelligent practitioners opinions may differ about the tion to the case as one of a kind which may at any time occur details'of Listerism, but there can be no doubt at all as to in a remote country district, and in which the family attendant, the prime advantages of absolute cleanliness in surgery ; and after fully explaining the possibilities to the friends, should cleanliness is really the ]most perfect antisepticism. On this operate without hesitation. There is no doubt whatever that in his recent address at the in districts on account point Sir William Stokes, opening many lives are lost annually outlying of the session of the College of Surgeons in Ireland, gave some of the cowardice of the practitioner?a cowardice fostered by are of the most serious consideration student's career. statistics which worthy many teachers during the on the part of tbose who may be still in doubt. He said : " " of an address "Asa of what we have in our power of warding Cremation formed the subject given by proof gained ' off and disarming what are not inaptly termed preventible' Sir Wells at the inaugural meeting of the Nottingham Spencer is diseases following wounds, all more or less connected with Medico-Chirurgical Society. The public sentiment gradually some con- in the world septic infection, let us briefly glance at statistics changing, and many persons of influence religious of burial on sani- nected with comparatively recent wars, for which I am in- are inclining towards the use of this method a murdered or debted to my friend, Sir William MacCormac. In the Crimean tary grounds. The medico-legal objection that War the number of men who lost their lives in the French poisoned body might be burned, and that discovery of crime be army was 95,615, of whom only 10,240 perished at the hands by subsequent exhumation would then impossible, of the enemy, the remainder succumbing to diseases resulting was answered by the argument that under proper regu- directly from their wounds. In the American war 95,000 men lations no human body could possibly be burned without far died from wounds, whilst 184,000, nearly double the number, more positive evidence of death fubm natural or known causes perished from septic affections consequent on them. A than was now required before burial, and that by promoting a more and remarkable for the better was observed in the Franco- cremation they were also leading to correct change true German war. In this campaign 28,282 died of their wounds, general system of registration and certification of the while only 12,253 died of disease. But the cause of death. The religious objection was met by the words preventible The greatest result of all yet obtained was in the Egyptian campaign of the late Bishop of Manchester and Canon Liddon. one?the fear of of 1882, in which not a single instance of death from pyaemia, strongest objection was the sentimental and the disinclination at a time septicemia, erysipelas, or hospital gangrene is recorded." offending relatives and friends, of bereavement and suffering to depart from ordinary routine On the question of "change in the methods of practice" or custom. Sir Spencer Wells firmly believed from his own Sir William Stokes, addressing students, says: "In your experience that, however painful it might be to make people professional life hereafter, if slow to accept new principles understand what a revolting change takes place after burial and practice, be also slow to reject them. Remember there is in the earth, and how dangerous it was to the living, very nothing so cheap or so nasty as senseless detraction; nothing little more was required to call forth a purer sentiment in" so vulgar, so stupid and contemptible as an unreasoning scep- favour of rapid purification by fire. Cremation is sometimes or not stated ticism ; and that indulgence in either both has infre- objected to on the score of expense ; but Sir Spencer quently brought persons into a position at once melancholy, that if the practice became general, the cost to a parish or and at the same time ludicrous. I allude more need not exceed ten for each cremation, and ' particularly union shillings to the hostility that was formerly evinced by practical' per- that from ten to twenty pounds would cover the expenditure sons to the now so and classes. many instruments of precision indispensable of each funeral of persons of the middle upper to every well-educated practitioner, and of late years, mainly, is still forward, and it is I regret to say, in the surgical ranks of our profession, to the The battle of the microbes going man of critical to principles and practices of as elaborated necessary for every medical judgment keep antisepticism by and The Pasteur and Lister. When we consider how recently we have himself abreast of the state of knowledge opinion. a note M. E. Metschnikoff heard antiseptic practices held up to contempt as little else British Medical Journal publishes by a the Cells the invading than fashionable, but essentially ephemeral craze, and its on the Struggle of of Organism against to the to have professors and advocates described as Microbes. Certain cells normal organism appear persons apparently microbes. These cells temporarily afflicted with a form of harmless lunacy, which the power of absorbing and digesting " The action of the phago- in time, and with a more extended may Metschnikoff calls phagocytes." experience, they of dead or be to recover from?we have a is not confined to the absorption degenerated reasonably expected good cytes with a means of of the detractors they also furnish the organism example humiliating position unthinking material; into the tissues. may eventually find themselves in." resisting microbes which may have penetrated made his researches on transparent animals, The experimenter of the are often invaded a such as which by parasites At recent of the Clinical of London daphnea, the form of meeting Society The of this in long several cases of were which yeast family. spores parasite, suppurative peritonitis reported the food into the intestine, through had been treated by the and needles, penetrate with opening abdomen, washing into the of the daphnea. As sponging the peritoneum. Mr. Richard Barwell read notes which they escape body-cavity " have done so, a commences between of a case in which it evident man had a soon as they struggle being that the bad or in of acute them and the white corpuscles, which, isolated groups, type peritonitis," the abdomen, was opened "in the middle line below the the and it, transforming it into shapeless umbilicus. A of gas, absorb spore destroy large quantity white are successful the is not of fseculent odour, No of viscus If the corpuscles daphnea escaped. rupture any granules. of interest in the was in its But sometimes?and here is the found, but lower part the peritoneum contained a saved. point the and then they of thick there were no conflict?the escape white corpuscles, quantity pus; adhesions; parts of spores invade a considerable number of the conidia the intestines were congested, and the membrane was some- germinate, and and kill it. it is stated that what thickened. Three sponges passed into the lowest the body of the animal Similarly part vertebrates there is a struggle of the cavity were withdrawn covered with tenacious floccu- in man and the other higher and the cell elements, but the phe- lent A smooth-nozzled funnel was then intro- between the microbes pus. glass deeply There are in man duced, and the lower part of the cavity washed out with ten nomena are of course more complicated. " the and the connec- pints of distilled water, at a temperature of 99 two kinds of phagocytes," leucocytes deg., bringing former Metschnikoff calls of and flocculi. After a tive tissue The away quantities pus sponging, second corpuscles. " the and was " and the latter Among smaller washing and sponging directed to the upper microphagi," macropliagi." of the also includes the cells _ wart. The abdomen was then sewn close without any drain. macrophagi he epithelial in all those which are provided The whole lasted an hour." The man convalesced alveoli, and general of operation pulmonary and which are capable and made a This with one large nucleus, rapidly, good recovery. case, commencing only there is nothing with a well illustrates the value of and solid bodies. In these conclusions blow, intelligence absorbing history and develop- a of well-known facts in the courage in practice. Not many years ago such patient would oontradictory and animal two of the lower forms of life in the vegetable inevitably have died for want of these qualities. From ment on the same lines the Mr. Barwell and a of research previous history and the symptoms, judged kingdoms ; continuance circumstances that make clear simple many the peritonitis had progressed to suppuration. The may be expected to and^ state to be enshrouded in mystery. of matters then might have been stated thus : Leave which now seem .

Load more