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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    putrefaction spreading into the wound, so that it does not seem wise to interpose anything that can interfere in the slightest degree with the antiseptic action of the dressing. And, in the second place, there is no chance of a suppurating sore being established by the direct action of the antiseptic upon the wound for a single day only. This leads me to speak of a condition of suppura- tion to which I have not before had occasion to advert— viz., the element of time. When the tissues are in a healthy state, no stimulus can induce them to suppurate. It appears that it is only when the tissues have been gradually degraded, under the influence of protracted abnormal stimulation, into the most imperfect of all tissues, which, when we see it at the surface of a sore, we term granulations, that they are in a condition, if further stimulated, to give birth to the still lower progeny of pus-corpuscles. In other words, granulation must pre- cede suppuration, and it is a process which requires days for its completion.^ Thus it is a familiar fact to aU surgeons that a recent wound in healthy tissues does not suppurate for three or four days when subjected to ordinary treatment—that is to say, the stimulus of putrefying material must act for three or four days upon the tissues before it can induce them to suppurate ; and when the first-formed pus is wiped from the wound, granulations may be seen upon the surface. An exception to this statement must he made for the case of the epi- thelium of some mucous membranes, the cells of which, originally of sim- ple structure, soon form pus-corpuscles under slight abnormal stimulation. While thus adopting the language of the “ Cellular Pathology,” elaborated by Virchow and others following the path first opened up by Goodsir, I may remark that my own experience has tended to convince me of the tnith of that doctrine.