[From Fernelius’ Universa Medicina, Geneva, 1679.1

BOOKSHELF BROWSING A PAPER THAT INAUGURATED A NEW

SURGICAL ERA

I N this age of hurry, most of us an hour in 193”. It is not the purpose of this

behind mapped out schedules of work, trifle to restate facts that ha1.e been retold

it is not unusual for the majorit? to hundreds of times in as many scientific

run as they read and to accept what is periodicals and books.

FIG. I. Lord Lister.

ofl’ered on ;I printed page without seeking Hokvever, every time one enters an

the original. operating room a n d contemplates the

The Lister centenar>- \vas ceIebrnted surgical miracles that are performed, in

28”

288 American Jonrnnl of Surgery A New SurgicaI Era AUGUST, rgzg

truth mereIy commonpktce routine sur- gica1 manouvres, he is forced to let his mind go back to that time when to undergo any surgica1 operation, no matter how sIight or minor, was to gamble with death. Before the time of Pasteur and Lister surgery was a serious probIem to both physician and patient.

Then it came to pass that in France Pasteur gave to the worId his briIIinnt discoveries. In Great Britain Lister put Pasteur’s discoveries to practica1 appIica- tion in his operating room and thus caused to be born the modern era of surgery. During the past fifty years surgery has made far greater advances than it did during the preceding twenty centuries. Lister, ridiculed at first by his coIIesgues and not given serious consideration at the time, opened the door and showed the way.

While Iooking through some old copies of the Lancet, we chanced upon the issue of March 16, 1867. On page 326 the running head reads, “New Method of Treating Compound Fracture, Abscess, etc.”

In the second coIumn, haIf way down the page is a modest heading:

On A New Method of Treating Compound

Fracture, Abscess, Etc. With Observations on the Condition

of Suppuration. By Joseph Lister, Esq., F.R.S.

Professor of Surgery in The University of GIasgow.

Lister’s writing was pubIished in several parts. In it he gave his reasons for attri- buting infection to germs carried by the dust-laden air and his method of carboIic acid treatment. For the most part the articIe is composed of case reports proving his points.

This series antedated his nrticIe, “On the Antiseptic PrincipIe of the Practice of Surgery,” which the more firmly put Lister on record as the advocate of his then origina method of surgica1 antisepsis.

In the first articIe of the Lancet, which strictIy marks the first of Lister’s writings on antisepsis, the foIIowing appears:

FIG. 2.

“Turning now to the question how the atmosphere produced decomposition of organic substances, we find that a flood of Iight has been thrown upon this most important subject by the phiIosophic researches of M. Pasteur, who has demon- strated by thoroughIy convincing evidence that it is not oxygen or to any of its gaseous constituents that the air owes this prop- erty, but to minute particIes suspended in it, which are germs of various Iow forms of life, Iong since reveaIed by the micro- scope, and regarded as merely accidental concomitants, resolving the compIex organ- ic compounds into substances of simpIer chemica1 constitution, just as the yeast pIant converts sugar into aIcoho1 and carbonic acid.

‘YEW SERIES VOL. VII, No. 2 Book Reviews

“AppIying these principles to the -treatment of compound fracture, bear- ing in mind that it is from the vitality of the atmospheric particIes that a11 the mischief arises, it appears that al1 that is requisite is to dress the wound w+th some materi capable of kiIJing these septic germs, provided that substance be found rehable for the purpose, yet not too potent as a caustic

“MJI attention having for severa years been d’irected to the subject of suppuration, more especially in its relation to decom- position, I saw that such a powerfu1 antiseptic icarboIic acid) was pecuIiarIy adapted for experiments with a view of eIucidnting that subject, and while I was engaged in the investigation the appIi- cabilit?; of carbolic acid for the treatment of compound fracture nat,urnIIy occurred to me.

“My first attempt of this kind was made in GIasgow RoyaI Infirmary in March, 1865, in a case of compound frac- ture of the leg. It proved unsuccessfu1, in consequence, as I now believe, of improper management; but subsequent trials have more than reaIized my most sanguine anticipations.”

1Ve reproduce a facsimiIe page of the first instaIIment of Lister’s early epoch- making contributions to the surgica1 Iitera- ture. The reader wiI1 be impressed with the modesty of its appearance. We wonder how many who read these earIy articles, sixty odd years ago, realized they were to be the means of inaugurating a new surgical era. T. S. W.

BOOK REVIEWS ‘This’ is the second of Harper’s series of

medical monographs and, as was to be expected of any monograph by this gifted author, it is full of meat ancf may be read to advantage by a11 physicians. The author states in his preface: “The chief excuse for this fittfe volume is that it is an attempt to present the practical phases of the complex in a sufficiently clear manner to f3e understood by afl, and particuIarIy to

’ ANGINA PECTORIS. By Hnrlow Brooks, M.D. N. Y., ~I:rrpcr & Bras., 1929.

stress the subject of treatment. It is not the treatment of the condition but rather that of the individuals who suffer from it Lvhich chiefly interests the writer.” This last sentence might we11 be applied by a11 physicians in practically a11 pathofogical concl~tions that they have to face.

The new volume of the Mayo Clinic JIono- graphs by Wiflius on “Clinical Efectrocardio- grams”’ is a splendid production which, according to the author’s preface, “has been devoted entirely to the subject of reading of the records themselves and their clinical significance. There has keen no :ltternpt to discuss the technic of electrocardiography, the preparation of records, theory, or tfw many controversial questions.” The author’s purpose

has been fully accomplished and a study of the records published cannot but be instructive to anyone interested in efectrocardic,gr:L~ll~. The reproduction in Iine instead of half tone, as is done in most of the other books, makes for greater ease of reading and it is hoped that other publishers wilf profit by the example set by Messrs. Saunders in this instance.

The annual appearanw of this volume2 represents to the oIder men the return visit of an old friend. Woufd that more of the writers of today availed themselves of this \-ofume, thereby avoiding much unnecessary rcpctition. The present volume, as usuaf, shows tfle most careful editing and is spfenclid~y illustrated, incfucling numerous coforetf plates. >leclicine today is really too complex to have justice done to the year’s progress in a singfe volume. This makes it a11 the more remarkable to see the thoroughness with which the Editors have covered the almost unlimited ground and still kept the volume under 600 pages. A spfendic1 index renders the volume extremely \-nlual)fe for quick reference. Full justice is done to the English and American literature of the past year though the references to German and French journals are not as profuse as formerly.

Here is a reprint of two outstanding articles3 in NeIson’s Loose-Leaf Living Medicine. Bound

lC~.~~~~a~ EI.ECTKOCARDIOGI~A~~S; Their Interpre- tation and Significance. By Frederick A. \kilIius, v.n. Phila., ‘Iv. B. Saunders CO., 1929.

2Tn~ IM-ERNATIOSAL MEIxcAL ASNL~~L. Ed. by Grcy F. Coombs, x.D., F.II.c.I’., ;cnd A. Kendle Short, M.D., T;.K.c.s. N. Y., U’illiam \Vood & Co., I C)ZO.

3 DISEASES OF THE THYROID GLAND. By Nellis Barnes Foster, M.D., :md Eugene H. Pool, v.~., N. ‘r’., Thomas NcIson cx- Sons, J~XJ.