CHAPTER I.
Infection of Wounds.
The greatest advance in modern surgery has been to show how wounds become infected and cause general blood poisoning. This applies both to wounds made by the knife of the Surgeon as well as to accidental injuries. The principles concerned in this matter involve not only the arrangements necessary for a severe and prolonged operation but also those required for the simple circumcision of an infant. It is therefore essential that those who perform ritual circumcision should be familiar with the elementary teachings of the Antiseptic System of Surgery which is now universally adopted even in the most trifling surgical proceedings.
Heavy responsibility lies upon the Mohel to carry out every case strictly in accord with the lessons of surgical cleanliness. Surgical Cleanliness begins where ordinary cleanliness leaves off. Its object is to destroy certain minute particles of matter which are invisible to the naked eye, but which are living organisms of a vegetable nature, able to grow very luxuriantly in blood, and wound discharges. Here they produce a poison which gets absorbed into the body, causing serious symptoms of disease; or they themselves enter the blood stream and circulate in it with even more disastrous results. These organisms can be observed under the microscope, but can only be seen by the naked eye when growing together in colonies after being planted in such substances as gelatine or broth, or on the surface of a slice of potato. They correspond exactly to the growth of mould or fungus on stale cheese or meat, or to the growth of yeast in fermenting grape juice. When seen separately under the microscope, or when growing in the mass they possess very distinct characters so that the expert is able to distinguish the one from the other, with the same confidence as a pear may be distinguished from a fig.
A large number of diseases is due to the growth in the body of certain of these organisms, and in many diseases we can be sure of always finding the particular one responsible for the condition, either in the blood or in the discharges from the body. This is notably the case in Consumption, Typhoid Fever, and Malarial Fever. We often know how the organism has obtained entrance into the body; it may be either by the lungs or the stomach, or in other words through air or through food.
We are however only concerned just now with the organisms which enter the body by means of an open wound.
These nearly all belong to one class—micro-cocci. They are minute round bodies about 1/25000 inch in diameter. They possess the peculiarity of growing together in clusters like grapes, or in chains. They are responsible for the diseased conditions of wounds which delay healing, for inflammation around wounds and for the general blood-poisoning which may result.