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The drains of the house you mean to stop in. I needn't tell you what drains mean. Blood-poisoning, typhoid, septic throats, breakings out in various parts of your body, and a very painful kind of death. For although O'Donoghue will do his best for you in the way of mitigating your sufferings he can't undertake to save your life."
If the gummatous tissue degenerates and breaks down, and especially if the overlying skin is perforated and septic infection is superadded, the bone disintegrates and exhibits the condition known as syphilitic caries; sometimes a portion of bone has its blood supply so far interfered with that it dies syphilitic necrosis.
The quinsy, the paralysis of the palate leading to return of the food through the nose, and the difficulty with speech and swallowing are typical results of this affection which was here complicated by a spread of the septic processes into the neck and chest, a not uncommon sequela of the disease.
But it evinces no prejudice to say that it is inefficient. For a moment study the facts. The organisms which were used to test the point at issue were those known as septic. The vast majority of these are inexpressibly minute. The smallest of them, indeed, is so small that, as I have said, fifty millions of them, if laid in order, would only fill the one-hundredth part of a cubic inch.
This, and the origin of contagion from putrid animal substances, seem to have given rise to the septic and antiseptic theory of these fevers.
Then on his way to Germany, before the wounds had properly healed that at least is our theory somewhere near the Belgian frontier he must have made his escape. What happened then, of course, during the winter and spring nobody knows; but when he reached our lines, the wounds were both in a septic state. There have been two operations for gangrene since he has been here.
When the charge impinges on one of the extremities at close range, we often have the opportunity of observing that the exit wound is larger, more ragged than that of entrance, and that its edges are everted; the extensive tearing and bruising of all the tissues, including the bones, and the marked tendency to early and progressive septic infection, render amputation compulsory in the majority of such cases.
Division of the carotid artery is fatal, and of the internal jugular vein very dangerous on account of entrance of air. Wounds of the larynx and trachea are not necessarily or immediately dangerous, but septic pneumonia is very apt to follow. Wounds of the throat inflicted by suicides are commonly situated at the upper part, involving the hyoid bone and the thyroid and cricoid cartilages.
One was killed by a shell falling on the E.M.O. One was in hospital crippled for life, and the third was brought in while I was there and died shortly after from septic pneumonia. Little did we think what was in store as we drank tea so merrily!
Of course, any such extensive surgical intervention even for serious affections would have been worse than useless under the septic conditions that would surely have prevailed if certain principles of antisepsis were not applied. Until comparatively recent years we have been quite confident in our assurance that antisepsis and asepsis were entirely modern developments of surgery.
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