Those who visited an ambulance ward during the war of 1870, especially those who were medical students, have preserved such a recollection of the sight that they do not, even now, care to speak about it. It was perpetual agony, the wounds of all the patients were suppurating, a horrible fetor pervaded the place, and infectious septicæmia was everywhere. “Pus seemed to germinate everywhere,” said a student of that time (M. Landouzy, who became a professor at the Faculty of Medicine), “as if it had been sown by the surgeon.” M. Landouzy also recalled the words of M. Denonvilliers, a surgeon of the Charité Hospital, whom he calls “a splendid operator ... a virtuoso, and a dilettante in the art of operating,” who said to his pupils: “When an amputation seems necessary, think ten times about it, for too often, when we decide upon an operation, we sign the patient’s death-warrant.” Another surgeon, who must have been profoundly discouraged in spite of his youthful energy, M. Verneuil, exclaimed: “There were no longer any precise indications, any rational provisions; nothing was successful, neither abstention, conservation, restricted or radical mutilation, early or postponed extraction of the bullets, dressings rare or frequent, emollient or excitant, dry or moist, with or without drainage; we tried everything in vain!” During the siege of Paris, in the Grand Hôtel, which had been turned into an ambulance, Nélaton, in despair at the sight of the death of almost every patient who had been operated on, declared that he who should conquer purulent infection would deserve a golden statue.
It was only at the end of the war that it occurred to Alphonse Guérin—(who to his intense irritation was so often confounded with another surgeon, his namesake and opponent, Jules Guérin)—that “the cause of purulent infection may perhaps be due to the germs or ferments discovered by Pasteur to exist in the air.” Alphonse Guérin saw, in malarial fever, emanations of putrefied vegetable matter, and, in purulent infection, animal emanations, septic, and capable of causing death.
“I thought more firmly than over,” he declared, “that the miasms emanating from the pus of the wounded were the real cause of this frightful disease, to which I had the sorrow of seeing the wounded succumb—whether their wounds were dressed with charpie and cerate or with alcoholized and carbolic lotions, either renewed several times a day or impregnating linen bandages which remained applied to the wounds. In my despair—ever seeking some means of preventing these terrible complications—I bethought me that the miasms, whose existence I admitted, because I could not otherwise explain the production of purulent infection—and which were only known to me by their deleterious influence—might well be living corpuscles, of the kind which Pasteur had seen in atmospheric air, and, from that moment, the history of miasmatic poisoning became clearer to me. If,” I said, “miasms are ferments, I might protect the wounded from their fatal influence by filtering the air, as Pasteur did. I then conceived the idea of cotton-wool dressings, and I had the satisfaction of seeing my anticipations realized.”
After arresting the bleeding, ligaturing the blood vessels and carefully washing the wound with carbolic solution or camphorated alcohol, Alphonse Guérin applied thin layers of cotton wool, over which he placed thicker masses of the same, binding the whole with strong bandages of new linen. This dressing looked like a voluminous parcel and did not require to be removed for about twenty days. This was done at the St. Louis Hospital to the wounded of the Commune from March till June, 1871. Other surgeons learnt with amazement that, out of thirty-four patients treated in that way, nineteen had survived operation. Dr. Reclus, who could not bring himself to believe it, said: “We had grown to look upon purulent infection as upon an inevitable and necessary disease, an almost Divinely instituted consequence of any important operation.”
There is a much greater danger than that of atmospheric germs, that of the contagium germ, of which the surgeon’s hands; sponges and tools are the receptacle, if minute and infinite precautions are not taken against it. Such precautions were not even thought of in those days; charpie, odious charpie, was left lying about on hospital and ambulance tables, in contact with dirty vessels. It had, therefore, been sufficient to institute careful washing of the wounds, and especially to reduce the frequency of dressings, and so diminish the chances of infection to obtain—thanks to a reform inspired by Pasteur’s labours—this precious and unexpected remedy to fatalities subsequent to operations. In 1873, Alphonse Guérin, now a surgeon at the Hôtel Dieu, submitted to Pasteur all the facts which had taken place at the hospital St. Louis where surgery was more “active,” he said, than at the Hôtel Dieu; he asked him to come and see his cotton-wool dressings, and Pasteur gladly hastened to accept the invitation. It was with much pleasure that Pasteur entered upon this new period of visits to hospitals and practical discussions with his colleagues of the Académie de Médecine. His joy at the thought that he had been the means of awakening in other minds ideas likely to lead to the good of humanity was increased by the following letter from Lister, dated from Edinburgh, February 13, 1874, which is here reproduced in the original—
“My dear Sir—allow me to beg your acceptance of a pamphlet, which I send by the same post, containing an account of some investigations into the subject which you have done so much to elucidate, the germ theory of fermentative changes. I flatter myself that you may read with some interest what I have written on the organism which you were the first to describe in your Mémoire sur la fermentation appelée lactique.
“I do not know whether the records of British Surgery ever meet your eye. If so, you will have seen from time to time notices of the antiseptic system of treatment, which I have been labouring for the last nine years to bring to perfection.
“Allow me to take this opportunity to tender you my most cordial thanks for having, by your brilliant researches, demonstrated to me the truth of the germ theory of putrefaction, and thus furnished me with the principle upon which alone the antiseptic system can be carried out. Should you at any time visit Edinburgh, it would, I believe, give you sincere gratification to see at our hospital how largely mankind is being benefited by your labours.
“I need hardly add that it would afford me the highest gratification to show you how greatly surgery is indebted to you.
“Forgive the freedom with which a common love of science inspires me, and