In this theatre was a stove which was always kept alight, winter and summer, night and day. The object was to have a fire at all times ready whereat to heat the irons used for the arrest of bleeding as had been the practice since the days of Elizabeth. Antiseptics were not yet in use. Sepsis was the prevailing condition in the wards. Practically all major wounds suppurated. Pus was the most common subject of converse, because it was the most prominent feature in the surgeon’s work. It was classified according to degrees or vileness. “Laudable” pus was considered rather a fine thing, something to be proud of. “Sanious” pus was not only nasty in appearance but regrettable, while “ichorous” pus represented the most malignant depths to which matter could attain.
There was no object in being clean. Indeed, cleanliness was out of place. It was considered to be finicking and affected. An executioner might as well manicure his nails before chopping off a head. The surgeon operated in a slaughter-house-suggesting frock coat of black cloth. It was stiff with the blood and the filth of years. The more sodden it was the more forcibly did it bear evidence to the surgeon’s prowess. I, of course, commenced my surgical career in such a coat, of which I was quite proud. Wounds were dressed with “charpie” soaked in oil. Both oil and dressing were frankly and exultingly septic. Charpie was a species of cotton waste obtained from cast linen. It would probably now be discarded by a motor mechanic as being too dirty for use on a car.
Owing to the suppurating wounds the stench in the wards was of a kind not easily forgotten. I can recall it to this day with unappreciated ease. There was one sponge to a ward. With this putrid article and a basin of once-clear water all the wounds in the ward were washed in turn twice a day. By this ritual any chance that a patient had of recovery was eliminated. I remember a whole ward being decimated by hospital gangrene. The modern student has no knowledge of this disease. He has never seen it and, thank heaven, he never will. People often say how wonderful it was that surgical patients lived in these days. As a matter of fact they did not live, or at least only a few of them. Lord Roberts assured me that on the Ridge at Delhi during the Indian Mutiny no case of amputation recovered. This is an extreme instance, for the conditions under which the surgeons on the Ridge operated were exceptional and hopelessly unfavourable.
The attitude that the public assumed towards hospitals and their works at the time of which I write may be illustrated by the following incident. I was instructed by my surgeon to obtain a woman’s permission for an operation on her daughter. The operation was one of no great magnitude. I interviewed the mother in the Receiving Room. I discussed the procedure with her in great detail and, I trust, in a sympathetic and hopeful manner. After I had finished my discourse I asked her if she would consent to the performance of the operation. She replied: “Oh! it is all very well to talk about consenting, but who is to pay for the funeral?”
III
THE TWENTY-KRONE PIECE
MORE than once in speaking at public meetings on behalf of hospitals I have alluded to my much valued possession—a twenty-krone piece—and have employed it as an illustration of the gratitude of the hospital patient.
The subject of this incident was a Norwegian sailor about fifty years of age, a tall, good-featured man with the blue eyes of his country and a face tanned by sun and by salt winds to the colour of weathered oak. His hair and his beard were grey, which made him look older than he was. He had been serving for three years as an ordinary seaman on an English sailing ship and spoke English perfectly. During his last voyage he had developed a trouble which prevented him from following his employment. Accordingly he had left his ship and made his way to London in the hope of being cured. Inquiring for the hospital of London he was directed to the London Hospital and, by chance, came into my wards. He had an idea—as I was told later—that the operation he must needs undergo might be fatal, and so had transferred his savings to his wife in Norway.
He was a quiet and reserved man, but so pleasant in his manner that he became a favourite with the nurses. He told them quaintly-worded tales of his adventures and showed them how to make strange knots with bandages. The operation—which was a very ordinary one—was successful, and in four or five weeks he was discharged as capable of resuming his work as a seaman. His ship had, however, long since started on another voyage.
One morning, three weeks after he had left the hospital, he appeared at my house in Wimpole Street. My name he would have acquired from the board above his bed, but I wondered how he had obtained my address. I assumed that he had called to ask for money or for help of some kind. As he came into my room I was sorry to see how thin and ill he looked, for when he left the wards he was well and hearty.