Volume 1
The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.
- Date:
- 1884
Licence: Public Domain Mark
Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
47/1220 page 15
![in other words, a “ convalescent home,” attached to it. Modern science has enabled us to determine the true nature of those conditions that lead to hospital infection, but sanitary practice has not as yet gone in advance of the admirable precepts laid down by Alanson a century ago. The mortality arising from inattention to these various hygienic conditions, whether want of cleanliness in the wound or want of pure air in the ward, is not a necessity of the operation, but rises and falls according as the treatment of the wounds, or the circumstances in which the patient is placed, depart more or less widely from those conditions that are necessary to the maintainance of health. The frequency of the occurrence of erysipelas in an institution may be taken as an indication of neglect in its sanitary arrangements. Pyaemia and septicaemia as a rule indicate in addition to general neglect, a want of cleanliness in the wounds, and reflect to a certain extent upon the Surgeon as well as the institution. These diseases are preventable, and ought to be pre- vented. Surely the first and most essential requisite of a hospital is that it be not a source of disease to its inmates—that those who are compelled to seek its aid shall not suffer from its effects. The exposure of a patient after an operation to the contagious emanations of septic diseases from other sick or wounded patients, is attended by the most fatal consequences. Whenever it is practicable, every case of septic disease, such as pyaemia, erysipelas, inflamed absorbents or veins, or hospital gangrene, should be rigorously excluded from the ward or room in which other patients with operation-wounds happen to be lying ; and, if possible, the same nurses, dressers, or surgeons should not be allowed to go from the infected to the healthy, nor should the same appliances, dressings, or sponges be used for both. When this is not possible, the danger of infection may be greatly diminished by the free use of antiseptics to the wounds both of the infected and the healthy. Great care also should be taken in the purification of the bedding that has been used by patients suffering from septic disease ; the blankets especially are apt to harbour infection long, and must be thoroughly purified. Every hospital Surgeon must have had abundant occasion to deplore many deaths after operation, arising from preventable causes due to want of attention to these simple precautions. 3 The Special Conditions directly excited by the Operation itself predisposed to by the circumstances that we have just been considering and which commonly lead to a fatal result, of which they are the immediate occasion, are the following :-Shock, Exhaustion, Haemorrhage, Gangrene, Tetanus iyaunia, Septicaemia, Erysipelas, and other Diffuse Inflammations These th-Tl rfM S° Vari0U8’ ?d C°mprise 80 raan-v distinct diseases, 0 bo S f° u ! m°re fclT raention them J referring the reader treated P m the h°dj of fche work>in which each is specially seveGtvS/T^y an Operation may prove fatal in various ways: from the nilf fthe 11nutllafc.lon> as in a case of double amputation ; from the tumoirro in!1!1?8 bc,ng ]raplicated’ as in fcll« removal from the face of large the stnto f me CTCCti011S ^1C Pase °f the skull ; from fear, or from causing i° TT8 depression, into which the patient has previously fallen & »m 0 feel the influence of an operation disproportionately to its](https://iiif.wellcomecollection.org/image/b21974081_0001_0047.jp2/full/800%2C/0/default.jpg)
