Blaker Family of Sussex - Reminiscences

Reminiscences

Antiseptic Surgery.



SOMEWHERE in the seventies, Lord Lister's wonderful observations on the subject of bacteria, and his practice based on them, began to be known. As happens in almost all great discoveries, the method of using antiseptics met with incredulity and opposition, and one very eminent Surgeon, attached to a large London Hospital, published an article in one of the journals eulogizing the advantages of bread poultice as compared with the antiseptic treatment of wounds. I recollect well the ridicule and difficulty I met with when I first used this new antiseptic method at the Hospital.

Although, at that time, our apparatus was very imperfect (we had only hand-spray, gauze, pro-tective, antiseptic wool, with carbolic acid lotion), and our knowledge of using it was also imperfect, I soon found that when "antiseptic precautions," as the new method was then termed, were used, we sometimes got primary union, which we had never done before, and wounds healed more rapidly and with less pain and constitutional disturbance than under the old treatment. It was, however, extremely mortifying after every care in the way of cleansing the hands, and soaking them and the instruments in carbolic acid lotion, and an opera-tion, as far as we could judge, was aseptic, that a colleague who did not believe in the method should put an unwashed hand into the middle of a wound and infect it! But in this I am convinced : that the spray of carbolic acid, 1 in 40, was of great service by washing away the germs so thoughtlessly introduced. Surgeons now felt themselves justified in cutting aseptic ligatures short and leaving them in the wound. Only those who recollect the length of time (at least nine days) required for the ligature, with one end left hang-ing from the wound, to separate, and the fear on the part of both patient and surgeon of primary hæmorrhage after the operation, and of secondary hæmorrhage during the separation of the ligature, can appreciate how great an advance this was.

Improvements in detail quickly followed, one of the first being disinfection of the skin at the site of the operation, and the sterilisation by heat and boiling of the instruments and dressings, till the present almost perfect system has been reached, and operations, which a few years ago were unheard of, are done now with comparatively little pain, and with almost a certainty of success.

Having now nearly reached the present time, "reminiscences" must cease. On looking back to the Surgery of one's younger days, although its principles, as shown by Hilton's book on Rest and Pain, and others, were well understood, one is struck with amazement at the improvement which science, with the aid of new and improved instruments, has been able to effect. Sir James Paget, a contemporary of many of us, when he found specks of trichina spiralis in a muscle, was obliged, as the legend goes, to take a specimen to the British Museum to examine it with a micro-scope. Now, when we go into a Bacteriological Laboratory and see the microscopes at present in use, and are shown the staining processes, the tubercle and other bacilli, and the phagocytes, and are told of the opsonins, may we not well wonder "whereunto this will grow?"

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