ANTISEPSIS
But the limits of surgical progress were not yet reached. Let me quote again from the address before alluded to:
“Even the introduction of anæsthesia, however, did not rid surgery of all its terrors. The acute pain of the operation was abolished, but the after-suffering, as I know only too well, in my early surgical days, was something dreadful to see. The parched lips of the poor sufferer, tossing uneasily during sleepless nights; wounds reeking with pus, and patients dying by scores from blood-poisoning, from erysipelas, from tetanus, from gangrene, were only too familiar sights in the pre-antiseptic days. Then, again, there arose one of these deliverers of the human race whose name can never be forgotten and whose fame will last so long as time shall endure. Jenner, Warren, and Lister are a triumvirate of names of which any profession may well be proud. Thank God, they all sprang from virile Anglo-Saxon loins! No praise, no reward, no fame is too great for them. That Lord Lister still lives to see the triumph of his marvellous services to humanity is a joy to all of us. And when the profession arose en masse, within the last few years, at the International Congress of Berlin, and at the meeting of the British Medical Association in Montreal, and welcomed him with cheer after cheer, it was but a feeble expression of gratitude for benefits which no words can express.
“Before Lister’s day erysipelas, tetanus, gangrene, and blood-poisoning in its various phases were the constant attendant of every surgeon. They were dreaded guests at almost any operation; and when in rare cases we obtained primary union without a drop of pus, without fever, and with but little suffering, it was a marvellous achievement. Now it is precisely reversed. The surgeon who does not get primary union without a drop of pus, with no fever, and with little suffering, asks himself—what was the fault in my technic? To open the head, the abdomen, or the chest thirty years ago was almost equivalent to signing the death-warrant of a patient. The early mortality of ovariotomy was about sixty per cent.; two out of three died. Now many a surgeon can point to a series of one hundred abdominal operations with a fatality of only two or three per cent. When Sir Spencer Wells recorded his first one thousand cases of ovariotomy it was calculated that after deducting the years which the patients who died from the operation would have lived had no operation been done the net result of the thousand cases was an addition of twenty thousand years to human life. One thousand ovariotomies under antiseptic precautions at the present would certainly add at least thirty thousand years to human life. Would not such a guerdon be enough for any man?
“This, too, is a direct result of laborious laboratory researches, beginning with the investigations of Liebig and Pasteur on fermentation. Lister went still further. Even before the discovery of the bacteria of suppuration, of tetanus, and of erysipelas he showed us experimentally how, by surgical cleanliness, we could avoid all infection and so banish these pests from our hospitals and bring life and health to many who otherwise would have perished from operations which are now perfectly safe.
“The mortality of compound fractures in the pre-antiseptic days was about sixty per cent. It was one of the most dreaded of all accidents. Its mortality now is perhaps not over three per cent., and the mortality from sepsis after such a fracture, in the hands of well-instructed surgeons, is almost nil. Prior to Lister’s day the mortality of major amputations varied from fifty to sixty-three per cent. Now it is from ten to twenty per cent. And so I might go on with operation after operation and show how they have become so safe that one need not dread any, saving exceptional cases.
“These two modern discoveries, anæsthesia and antisepsis, have utterly revolutionized modern surgery. They have made possible operations which, by reason of their length and pain and danger, were utterly unjustifiable in former days, but are now the daily occupation of a busy surgeon. And, far better than this, they have enabled us to bring to homes and hearts, which otherwise would have been broken up and wrung with sorrow, the comfort of life restored to dear ones upon whom depended the happiness and support of the families. Translate figures into happy hearts and prosperous homes if you can, and then you can tell me what Warren and Lister have done for humanity!”
The result of these two wonderful discoveries has been to separate us from the surgical past, as by a great gulf.
“Great theologians, such as a Calvin or a Jonathan Edwards, were they recalled to life, could discourse as learnedly as ever of predestination and free will; great preachers, as a Beecher or a Spurgeon, could stir our souls and warm our hearts as of old; great jurists, as a Justinian or a Marshall, could expound the same principles of law which hold good for all time; great forensic orators, as a Burke or a Webster, could convince us by the same arguments and arouse us by the same invectives or the same eloquence that made our fathers willing captives to their silver tongues. But to-day, so rapid has been our surgical progress, a Velpeau, a Sir William Ferguson, or a Pancoast, all of whom have died within the last thirty years, could not teach modern surgical principles nor perform a modern surgical operation. Even our every-day surgical vocabulary—staphylococcus, streptococcus, infection, immunity, antisepsis and asepsis, toxin and antitoxin—would be unintelligible jargon to him; and our modern operations on the brain, the chest, the abdomen, and the pelvis would make him wonder whether we had not lost our senses, until, seeing the almost uniform and almost painless recoveries, he would thank God for the magnificent progress of the last half-century, which had vouchsafed such magical, nay, such almost divine, power to the modern surgeon.”