Volume 1

The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.

  • John Eric Erichsen
Date:
1895
Catalogue details

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 University of Leeds Library. The original may be consulted at The University of Leeds Library.

    40/1274 (page 8)
    that surround one Avho is exposed to the pecuhar perils that arc necessarily connected with military hospitals and ambulances in time of war, and which will be more fully described in the chapter on Gunshot wounds. In private practice, ill results may follow operations from three diiferent causes, viz. : self-infection of the patient, in consequence of the retention of decomposing secretions in the wound ; conveyance of infection by the Surgeon ; and general faulty sanitary arrangements. In hospital practice these different sources of danger must necessarily exist to the same if not to a greater extent than in private. In hospital, however, just as in private practice, these particular dangers are all preventable, and disease of a septic character ought not to be allowed to generate itself through their medium. The fi'equency of such an occurrence is in the direct ratio of the want of hygienic attention bestowed upon the patient. The air of large towns in which the majority of hospitals must necessarily be situated is more or less loaded with impurities. The normal parts per 1,000 of carbonic acid gas is always exceeded, the amount sometimes reaching as high as 5 or '55, and there is moreover always a deficiency, often a total absence, of ozone. The amount of solid impurity is also very considerable. It has long been known that the atmosphere of inhabited houses and cities is loaded with minute particles of organic matter in suspension. Forty years ago Pouchet demonstrated the presence of starch granules in the dust deposited in a room. In 1861 Pasteur proved that the spores of some of the higher fungi are always to be found in the air of Paris. Tyndall also demonstrated by numerous experiments that a large proportion of the dust of the air is composed of organic matter. Further, microscopic observations by Pouchet and others showed that the air of inhabited rooms contains in suspension scaly epithelium, fragments of human hair and of cotton, linen and wool from the clothing. In hospital wards dried pus cells have also been found. All these impurities may be recognised without difficulty by microscopic examination of dust collected from the air. The experiments of Pasteur, Tyndall, Lister, and many others, further conclusively proved that the air contains minute solid particles, which act as ferments on dead organic matter, giving rise to such processes as the ordinary putrefaction of albuminoid substances, the lactic acid fermentation of milk, &c. That these particles are organised bodies, minute fungi or their spores, is now uni- versally acknowledged. The number and nature of these organisms has been made the subject of daily observation by Miquel in the Observatory of Montsouris in Paris for many years past, and many interesting facts have been ascertained. His method of observation consists in drawing a measured quantity of air through a glass bulb filled with a solution of Liebig's extract of beef, which forms a suitable cultivating medium for microscopic fungi of almost all kinds. The fluid is, of course, freed from all living organisms before tlie experiment by prolonged boiling. If, after the admission of air, microscopic organisms appear in the fluid, he assumes that the quantity drawn through contained at least one microscopic fungus or its spore. Another mode of investigation which, in the hands of Koch and others, has given results confirmatory of those obtained by Mi(]uel, is to expose to the air for a fixed time a measured surface of properly prepared nutrient gelatine freed from organisms by heat. The single organisms or spores wliich fall on the gelatine soon develop into colonies visible to the naked eye, and by