Further, bacteria may gain access to devitalised tissues by way of the
blood-stream, being carried hither from some infected area elsewhere in
the body.
_The Antiseptic System of Surgery._--Those who only know the surgical
conditions of to-day can scarcely realise the state of matters which
existed before the introduction of the antiseptic system by Joseph
Lister in 1867. In those days few wounds escaped the ravages of pyogenic
and other bacteria, with the result that suppuration ensued after most
operations, and such diseases as erysipelas, pyaemia, and "hospital
gangrene" were of everyday occurrence. The mortality after compound
fractures, amputations, and many other operations was appalling, and
death from blood-poisoning frequently followed even the most trivial
operations. An operation was looked upon as a last resource, and the
inherent risk from blood-poisoning seemed to have set an impassable
barrier to the further progress of surgery. To the genius of Lister we
owe it that this barrier was removed. Having satisfied himself that the
septic process was due to bacterial infection, he devised a means of
preventing the access of organisms to wounds or of counteracting their
effects. Carbolic acid was the first antiseptic agent he employed, and
by its use in compound fractures he soon obtained results such as had
never before been attained. The principle was applied to other
conditions with like success, and so profoundly has it affected the
whole aspect of surgical pathology, that many of the infective diseases
with which surgeons formerly had to deal are now all but unknown. The
broad principles upon which Lister founded his system remain unchanged,
although the methods employed to put them into practice have been
modified.
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