Again, a portion of cotton wool was impregnated with about one two-hundredth part of its weight of carbolic-acid vapour, and the surface of a granulating sore and surrounding skin was washed with a dilute solution of the acid. A piece of oiled silk of the size of the sore was then applied, to prevent the dressings from sticking through becoming dry. Over this was placed a piece of folded linen rag of rather larger size, and similarly impregnated with carbolic acid vapour to the cotton wool; this being intended to absorb any discharge from the sore. Lastly, an overlapping mass of carbolised cotton wool was securely fixed over all. The result was that although all chemical antiseptic virtue left the dressing by evaporation of the volatile carbolic acid in a day or two, yet putrefaction was practically excluded by the cotton wool for any length of time.
Subsequently another variety of protective material was adopted, namely antiseptic gauze, a loose cotton fabric, the fibres of which were impregnated with carbolic acid lodged in insoluble resin. The interstices between the fibres were kept free from these ingredients, so that the porous fabric might readily absorb discharges. By arranging this in a sufficient number of layers and covering the whole with a layer of mackintosh, the discharge was compelled to pass through the whole length of the antiseptic dressing. Thus it was almost certain that if no putrefactive mischief were left in a wound or abscess, none would enter it, however profuse might be the discharge.
If a wound was presented for treatment, inflicted by some other than the surgeon, some dust was sure to have been introduced, which probably contained putrefactive germs. The energy of these had first to be destroyed by washing the raw surface with some strong antiseptic agent. But in operating upon a previously unbroken skin, Mr. Lister considered that he could prevent the septic particles from entering at all, by operating in an antiseptic atmosphere. This was provided by producing a shower of spray of carbolic acid of the finest character. This answered exceedingly well when the solution producing the spray consisted only of one part of carbolic acid to 100 parts of water.
Here we must limit our detailed account of the antiseptic system. Under it large abscesses are opened, the matter pressed out, and fresh matter does not form, and cures are effected in severe cases which scarcely ever used to be cured. Arteries are tied with a security before unknown. Amputations and excisions are effected with a safety and diminished mortality quite surprising. Even senile gangrene shows hopeful results which were previously quite out of question. Pyæmia, hospital gangrene, and erysipelas have been almost banished from wards where the system is properly carried out. Recently a modification has been introduced, in which there is employed, not a volatile material as in the case of carbolic acid, but a dilute solution of corrosive sublimate combined with albumen. Gauze is now prepared for Sir Joseph Lister steeped in this substance, and it may become generally adopted; but it does not appear likely to supersede carbolic acid for the purification of instruments, sponges, the skin, or as a substitute for the carbolic spray. The particular form of antiseptic is a matter of detail, on which improvement may long continue to be made; but the development of the essential idea of preventing the access of germs which can cause putrefactive changes by one method or another, and the destruction of them as far as possible when they have obtained access, will remain connected with Sir Joseph Lister as an achievement of the highest force; indeed his name seems likely to give a new word to our language, namely Listerism, by which the essential features of his system are understood.
Professor Lister was awarded a Royal Medal by the Royal Society of London in 1880, having previously received the high distinction of the MacDougall Brisbane Prize from the Royal Society of Edinburgh in 1875, for a remarkable paper on the Germ Theory of Fermentative Changes. He was created a baronet in December 1883. The universities of Cambridge, Edinburgh, and Glasgow had conferred upon him the honorary degree of LL.D., and Oxford that of D.C.L. He has been for some years Surgeon to King’s College Hospital, having succeeded Sir William Fergusson.
FOOTNOTES:
[12] Monthly Microscopical Journal, 1870, iii. p. 143.
[CHAPTER XIX.]
SIR THOMAS WATSON, SIR DOMINIC CORRIGAN, SIR WILLIAM GULL, AND CLINICAL MEDICINE.
The Nestor of the medical profession, Sir Thomas Watson, died in 1882, at the great age of ninety, universally beloved and honoured. Yet he had written but one extended work, the “Lectures on the Principles and Practice of Physic,” and had made no striking discovery. But to have written a book which every cultivated practitioner reads, and reads with delight and satisfaction, is an achievement given to few, many though there be who aim at it. And Sir Thomas Watson’s personal character was as unique as his advice was valuable.
Thomas Watson was born on March 7th, 1792, at Montrath (now Dulford) House, near Cullompton, Devonshire, where his father, Joseph Watson, a Northumbrian by family, was then living. He was educated at Bury St. Edmund’s Grammar School, where he was a schoolfellow with Blomfield, afterwards Bishop of London, and a great friend of Watson’s. In 1811 he entered at St. John’s College, Cambridge, and became tenth wrangler and fellow of his college. At that time only two fellows of St. John’s could retain their fellowships without taking orders, and one of these must study medicine. This circumstance availed to turn Watson’s attention to medicine in 1819 at the age of 27, when he entered St. Bartholomew’s Hospital, and came under the powerful influence of Abernethy. During the session 1820-1 he attended medical lectures at Edinburgh University, and in 1822 received his licence to practise from Cambridge. But academical pursuits were continued, and Watson took private pupils, among whom was Lord Auckland, afterwards Bishop of Bath and Wells, and served the office of proctor in 1823-4. In 1825 he took his M.D. degree, and married Miss Jones, niece of Turner, Dean of Norwich and Master of Pembroke College. Soon afterwards he established himself as a physician in Henrietta Street, Cavendish Square, London, in which street he continued to live for fifty-seven years. His wife died, to his lasting regret, five years later, leaving him with one son and daughter, to whom he was devotedly attached.