The Classic: On the Antiseptic Principle in the Practice of Surgery

It may state two separate claims as one.

The method of applying a piece of lint dipped in acid, overlapping sound skin, covered with a tin cap, succeeded well with wounds of moderate size; in all the many cases treated by Lister or his house surgeons, not a single failure occurred.

“This method certainly succeeded well with wounds of moderate size; and, indeed, I may say that in all the many cases of this kind which have been so treated by myself or my house surgeons, not a single failure has occurred.”

It may state two separate claims as one.

When an abscess is evacuated on the antiseptic principle, the pyogenic membrane ceases to suppurate, furnishing merely a trifling amount of clear serum, and rapidly contracts and coalesces.

“But when the evacuation is effected on the antiseptic principle, the pyogenic membrane, freed from the influence of the former stimulus without the substitution of a new one, ceases to suppurate (like the granulations of a sore under metallic dressing), furnishing merely a trifling amount of clear serum, and, whether the opening be dependent or not, rapidly contracts and coalesces.”

It may state two separate claims as one.

In a man with severe compound fracture of both bones of the left leg, after cessation of sanious discharge under use of the paste, no pus appeared, and he was treated as if the fracture were simple.

“I have at present in the hospital a man with severe compound fracture of both bones of the left leg, caused by direct violence, who, after the cessation of the sanious discharge under the use of the paste, without a drop of pus appearing, has been treated for the last two weeks exactly as if the fracture were a simple one.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

More or less pus may appear after the lapse of the first week, and the larger the wound the more likely this is to happen.

“More or less pus may appear after the lapse of the first week; and the larger the wound the more likely is this to happen.”

It may state two separate claims as one. The quote only partly states this claim.

In a boy with severe injury to the left arm, antiseptic treatment avoided amputation, and although slight pus appeared, he remained free from unfavourable symptoms and the bone became firm.

“I left behind me in Glasgow a boy, thirteen years of age, who between three and four weeks previously met with a most severe injury to the left arm, which he got entangled in a machine at a fair.”

It may state two separate claims as one.

In abscesses, the results of antiseptic treatment have been extremely satisfactory and in harmony with the pathological principles indicated.

“The next class of cases to which I have applied the antiseptic treatment is that of abscesses. Here, also, the results have been extremely satisfactory, and in beautiful harmony with the pathological principles indicated above.”

It may state two separate claims as one.

In cases where pus formation depended on disease of bone, antiseptic treatment yielded in a few days only a trifling discharge, and frequently pus production ceased from the moment of evacuation of the original contents.

“The most remarkable results of this practice in a pathological point of view have been afforded by cases where the formation of pus depended upon disease of bone. Here the abscesses, instead of forming exceptions to the general class in the obstinacy of the suppuration, have resembled the rest in yielding in a few days only a trifling discharge; and frequently the production of pus has ceased from”

It may state two separate claims as one.

In a boy with compound fracture of the leg admitted eight and a half hours after the accident, all local and constitutional disturbance was avoided by means of carbolic acid, and the bones were firmly united five weeks after his admission.

“Thus I have now under my care in the Glasgow Infirmary a boy who was admitted with compound fracture of the leg as late as eight and a half hours after the accident, in whom nevertheless all local and constitutional disturbance was avoided by means of carbolic acid, and the bones were firmly united five weeks after his admission.”

It may state two separate claims as one.

Dressing a granulating sore with the putty produces pus in twenty-four hours although the application is perfectly antiseptic; the larger the amount of carbolic acid in the paste, the greater the quantity of pus formed, provided a caustic proportion is avoided.

“Another instructive experiment is to dress a granulating sore with some of the putty above described, overlapping the sound skin extensively, when we find in the course of twenty-four hours that pus has been produced by the sore, although the application has been perfectly antiseptic; and, indeed, the larger the amount of carbolic acid in the paste the greater is the quantity of pus formed, prov”

It may state two separate claims as one. The quote only partly states this claim.

In a volunteer whose rifle burst and injured his thumb, carbolic acid applied to the raw surface and dressing as for compound fracture resulted in consolidation without a drop of matter, leaving only a linear cicatrix and preserving thumb movements and hand grasp.

“In April last a volunteer was discharging a rifle, when it burst, and blew back the thumb with its metacarpal bone, so that it could be bent back as on a hinge at the trapezial joint, which had evidently been opened, while all the soft parts between the metacarpal bones of the thumb and fore-finger were torn through.”

It may state two separate claims as one.

A case of strangulated inguinal hernia in which half a pound of thickened omentum was removed healed without deep-seated suppuration, tenderness of the sac, or fever; amputations including one below the knee remained free from constitutional symptoms.

“Thus I have had a case of strangulated inguinal hernia, in which it was necessary to take away half a pound of thickened omentum, heal without any deep-seated suppuration or any tenderness of the sac or any fever; and amputations, including one immediately below the knee, have remained absolutely free from constitutional symptoms.”

It may state two separate claims as one.

Since the antiseptic treatment has been brought into full operation, Lister's wards, though under the same circumstances as before, have completely changed their character; during the last nine months not a single instance of pyaemia, hospital gangrene, or erysipelas has occurred in them.

“But since the antiseptic treatment has been brought into full operation, and wounds and abscesses no longer poison the atmosphere with putrid exhalations, my wards, though in other respects under precisely the same circumstances as before, have completely changed their character; so that during the last nine months not a single instance of pyaemia, hospital gangrene, or erysipelas has occurred in”

• AssumptionRests on an assumption: Lister's wards were under precisely the same circumstances as before except for the introduction of the antiseptic treatment.

It may state two separate claims as one.

A solution of carbolic acid in twenty parts of water may be relied on for destroying any septic germs that may fall upon a wound during an operation; and the paste applied as for compound fractures gives excellent results for preventing subsequent introduction of germs.

“I am, however, prepared to go so far as to say that a solution of carbolic acid in twenty parts of water, while a mild and cleanly application, may be relied on for destroying any septic germs that may fall upon the wound during the performance of an operation; and also that for preventing the subsequent introduction of others, the paste above described, applied as for compound fractures, gives ex”

• AssumptionRests on an assumption: Carbolic or phenic acid exercises a peculiarly destructive influence upon low forms of life and is the most powerful antiseptic known.

It may state two separate claims as one. The quote only partly states this claim.

In a blacksmith with ulceration of cartilage in the left elbow, opening the abscess on the antiseptic principle led to sound closure of the sinus and restoration of joint movement two months later.

“The patient was a blacksmith who had suffered four and a half months before I saw him from symptoms of ulceration of cartilage in the left elbow.”

It may state two separate claims as one.

For antiseptic treatment of an abscess to be satisfactory, the abscess must be seen before it has opened; then, except in rare cases, there are no septic organisms in the contents, so it is needless to introduce carbolic acid into the interior.

“In order that the treatment may be satisfactory, the abscess must be seen before it has opened. Then, except in very rare and peculiar cases, 5 there are no septic organisms in the contents, so that it is needless to introduce carbolic acid into the interior.”

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It may state two separate claims as one.

The mere contact of a foreign body does not of itself stimulate granulations to suppurate; whereas the presence of decomposing organic matter does.

“Further, it shows that the mere contact of a foreign body does not of itself stimulate granulations to suppurate; whereas the presence of decomposing organic matter does.”

It may state two separate claims as one.

Granulations have no inherent tendency to form pus, but do so only when subjected to a preternatural stimulus.

“This simple experiment illustrates the important fact, that granulations have no inherent tendency to form pus, but do so only when subjected to a preternatural stimulus.”

It may state two separate claims as one.

In an ordinary abscess before it is opened, the stimulus maintaining suppuration is derived from the presence of pus pent up within the cavity; when a free opening is made, this stimulus is removed, but atmospheric decomposition causes pus to be generated in greater abundance.

“In an ordinary abscess, whether acute or chronic, before it is opened, the stimulus which maintains the suppuration is derived from the presence of the pus pent up within the cavity. When a free opening is made in the ordinary way, this stimulus is got rid of; but the atmosphere gaining access to the contents, the potent stimulus of decomposition comes into operation, and pus is generated in gre”

It may state two separate claims as one.

These evils are entirely avoided by the antiseptic treatment, so that limbs which otherwise would be unhesitatingly condemned to amputation may be retained with confidence of the best results.

“For these evils are entirely avoided by the antiseptic treatment, so that limbs which otherwise would be unhesitatingly condemned to amputation may be retained with confidence of the best results.”

• AssumptionRests on an assumption: Carbolic or phenic acid exercises a peculiarly destructive influence upon low forms of life and is the most powerful antiseptic known.

It may state two separate claims as one.

Carbolic acid, though it prevents decomposition, induces suppuration by acting as a chemical stimulus; putrescent organic materials operate in the same way.

“The carbolic acid, though it prevents decomposition, induces suppuration-obviously by acting as a chemical stimulus; and we may safely infer that putrescent organic materials (which we know to be chemically acrid) operate in the same way.”

• AssumptionRests on an assumption: Putrescent organic materials are chemically acrid.

It may state two separate claims as one.

When a wound is very large, the crust beneath the rag may be insufficient to protect the raw surface from the stimulating influence of carbolic acid in the putty, leading to conversion of tissues into granulations and formation of more or less pus.

“Hence it is easy to understand how, when a wound is very large, the crust beneath the rag may prove here and there insufficient to protect the raw surface from the stimulating influence of the carbolic acid in the putty, and the result will be, first, the conversion of the tissues so acted on into granulations, and subsequently the formation of more or less pus.”

It may state two separate claims as one.

Carbolic acid stimulates only the surface to which it is first applied, and every drop of discharge weakens the stimulant by diluting it; decomposition is a self-propagating and self-aggravating poison that spreads into recesses and becomes more acrid until it can destroy tissue vitality.

“There is, however, this enormous difference between the effects of carbolic acid and those of decomposition-viz. that carbolic acid stimulates only the surface to which it is first applied, and every drop of discharge that forms weakens the stimulant by diluting it. But decomposition is a selfpropagating and self-aggravating poison; and if it occurs at the surface of a severely injured limb, it”

It may state two separate claims as one. The quote only partly states this claim.

The change in the wards is due to the antiseptic treatment, and the importance of this fact can hardly be exaggerated.

“As there appears to be no doubt regarding the cause of this change, the importance of the fact can hardly be exaggerated.”

• AssumptionRests on an assumption: Lister's wards were under precisely the same circumstances as before except for the introduction of the antiseptic treatment.