Remarks on a case of compound dislocation of the ankle with other injuries : illustrating the antiseptic system of treatment / by Joseph Lister.

  • Lister, Joseph, Baron, 1827-1912.
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on a case of compound dislocation of the ankle with other injuries : illustrating the antiseptic system of treatment / by Joseph Lister. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    L though they do produce suppuration when applied con- tinuously to a recent wound, are superficial in their action and utterly trivial compared with the deep and ^ virulent efiFects of putrefaction, which, indeed, often causes death by irritation and blood-poisoning before i suppuration has had time to be established. These conclusions may be exhibited in a diagrammatic ! form as follows :— Causes of Suppuration. ( Througli excited nervous 1 7- « , < ,.® y Inflammatory. action. ) ^ J From the direct action of ( a. Putrefactive. t stimulating salts. \ h. Antiseptic. This scheme, though not strictly exhaustive,^ applies to almost all circumstances met with in surgery; and it will be found to conduce to clearness to speak of sup- puration as inflammatory, putrefactive, or antiseptic, according to the circumstances in which it occurs.^] If the use of the protective be so advantageous, you may naturally inquire why I do not employ it at the first dressing. The reason is twofold. In the first place, there must necessarily be a considerable discharge of blood and serum during the first twenty-four hours, and hence this is the period in which there is greatest risk of ^ The group a ought to include the products of other ferments besides those of putrefaction. For I am satisfied that inodorous ferments sometimes occur in the animal fluids, and produce salts which stimulate to suppuration. Also viruses inducing suppuration are very probably of the same essential nature (ferments), though some at least are odourless, as in the case of erysipelas. Again, the group h, to be complete, should include salts which, though not the products of putrefaction, cannot be said to be antiseptic,’ such as dilute chloride of sodium, etc. 2 Any special case, not falling under the scheme, may be caUed according to its special nature; thus we may speak of erysipelatous suppuration, variolous suppuration, etc. Abnormal stimulation f of the I tissues, ) B