The antiseptic method in relation to drainage of the peritoneum in abdominal surgery / by J. Knowsley Thornton.

  • Thornton, John Knowsley.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The antiseptic method in relation to drainage of the peritoneum in abdominal surgery / by J. Knowsley Thornton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    form aseptic ovariotomy, because the cyst may already contain the causes of putrefaction, and if this be so in a difficult case with adhesions, we cannot be certain that some of the putrid material will not pass over portions of the wound or peritoneum without being rendered innocuous. The mere fact that the fluid is not offen- sive is no guarantee that it contains no causes of putrefaction, for I have found fluidfull of active bacteria^ yet without odour; moreover, when the spray is playing over everything, it is difficult to detect odour unless it be very powerful, and one cannot pause in an ovari- otomy to examine the fluid microscopically. I have observed many facts which make it probable, that the causes of putrefaction may be present in a cyst, with- out the patient presenting the usual symptoms of cyst putridity, and without odour from the cyst contents. And yet, when brought in contact with fresh blood, serum, and wounded tissues, these latent causes of putrefaction become active. They are in fact dormant in the cyst. This is too difficult a subject to discuss here, and I want more facts; but it is necessary I should mention it, to make my views on drainage intelligible. In the case of very large tumours, I do not think that any one spray producer, however powerful, is sufficient to produce a large enough cloud, and I shall record a case in which the patient died of septicaemia, of which I believe a too small spray to be the explanation, though it might have arisen from numerous tappings without antiseptic precautions, before the case came under my care. The fever-inducing power of fluids effused from surgical wounds, must also be kept in view, although this also is a subject on which we want the light of extended observation and experience.
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