These organisms are very abundant in the dust of rooms, on dirty clothes and unclean general surroundings, and there can be no doubt that everybody is often infected by them. But fortunately disease results only rarely, because there are special powers resident in the vital tissues which enable them successfully to resist the poisonous effects of these organisms. There are however certain circumstances in which they are liable to be more harmful than in others.
1) When they are absorbed in especially large numbers.
2) When absorbed in an especially active state.
3) When the body is in a condition of ill-health from whatever cause.
4) In the presence of cold.
Each one of these circumstances is of special importance in relation to circumcision and may be commented on as follows.
1) The slightest departure from scrupulous cleanliness either on the genitals of the infant, on the instruments or dressings used, or on the hands of the Mohel enormously increases the number of microbes which may possibly infect the wound. Hence the necessity for absolute ordinary cleanliness before resorting to antiseptic measures.
2) It is well known that these organisms exist in a very virulent form in unhealthy wounds, in boils and in abscesses, and the worst cases of blood poisoning have resulted from the direct infection of a healthy wound from an unhealthy one. For this reason all the precautions in regard to the disinfection of the hands, which will be referred to subsequently, must be carried out with rigorous care, when there has been any possibility of their having come in contact with such sources of infection.
3) The natural protective power of the body against infection is diminished when the general health is below the normal standard. This occurs in infants mainly, when they are premature, or suffering from jaundice, sickness or diarrhœa, congenital disease of the heart or other organs. In these circumstances the circumcision must be delayed.