The present aspect of the antiseptic question : being the substance of the oration for the year 1883, delivered before the Medical Society of London / by Edward Lund.

  • Lund, Edward.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: The present aspect of the antiseptic question : being the substance of the oration for the year 1883, delivered before the Medical Society of London / by Edward Lund. Source: Wellcome Collection.

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    of it, that this favourable end is attained. The pus which bedews the highly vascular surfaces of advancing granulations in the healing of a wound, is but the outcome of excessive vascular action, and the production of it is often a relief to vascular tension and the attendant pain. Hence it is wont to be regarded by the patient and the lookers-on as a thing to be desired, and to be hailed as the harbinger of a highly favourable crisis. But it is simple superfluity, and comes of vital action uselessly in excess, for if the granulations which form new tissue are undisturbed, and are allowed to go on g rowing slowly, so as to fill up the yawning cavity of a wound, they will often do so without secreting any pus at all from their highly vascular surfaces,—at all events, if any, it shall be so small in quantity as to be nearly unobservable. But these results are only seen where the conditions are specially favourable. Assuming, however, that in spite of every effort to restrain this excess of action in these local changes, we fail to do so,— it is then that still more unfavourable conditions are developed on the surface of the wound, not so much as an inevitable consequence, but rather as a more advanced result of these identical changes. Ulceration sets in,—ulceration of tissue already formed, either originally, as the old tissue of the part, or newly deposited in the early stage of repair. This molecular decay, this successive necrosis of small particles of tissue, which may be washed away in the stream of pus so constantly present in ulceration, will bring about a condition of things the very opposite to what we seek for in the healing of a wound, for in ulceration tissues are pulled down cell by cell; there is evident loss of substance, and the chasm of the wound is visibly enlarged. Or, again, perhaps from the original nature of the wound itself, the injury to nerves, or to blood vessels, with vascular obstruction and insufficient supply of blood, from constitutional exhaustion, or from other unhealthy states of the body, this death of tissue proceeds on a larger scale. We have then to deal with the sloughing