George Hogarth Pringle and the mystery of the first antiseptic operation in Australia.

EARLY LIFE: George Hogarth Pringle, later an associate of Joseph Lister, was born in Kintail, Scotland in 1830. In 1854, he worked as a dresser at the Royal Infirmary, Edinburgh with Joseph Lister. After serving in the Crimean War, he settled in New South Wales and began practice in Parramatta. PRINGLE AND ANTISEPTIC SURGERY: In October 1867, Pringle performed the first operation in Australia using the antiseptic principles advocated 6 months previously in the first of a series of articles published in The Lancet by Joseph Lister. Mystery surrounds how Pringle was able to adopt Lister's principles so quickly. Lister and Pringle had been friends in Edinburgh and previous writers have hypothesized that the two men corresponded whilst another has suggested Pringle was using antiseptic principles prior to Lister's work being published. Both these scenarios are unlikely. The Lancet appears to have been available in Australia within 4 months of publication. CONCLUSION: The conjunction of an appropriate case and the arrival of a recent copy of The Lancet highlighting Lister's work is the likely source of Pringle's decision to apply antiseptic principles.

[The treatment of wounds during World War I].

The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases. In the first part of this article, we describe the surgical procedures and medical therapies carried out by Italian physicians during the First World War, with the aim of treating wounded soldiers in this pre-antibiotic era. Antibacterial solutions, such as those of Dakin-Carrel and sodium hypochlorite and boric acid, the tincture of iodine as well as the surgical and dressing approaches and techniques used to remove pus from wounds, such as ignipuncture and thermocautery or lamellar drainage are reported in detail. In the second part of the paper, the organization of the Italian military hospitals network, the systems and tools useful to transport wounded soldiers both in the front lines and in the rear is amply discussed. In addition, the number of soldiers enrolling, and those dying, wounded or missing during the Great War on the Italian front is estimated.

[Healing Dental and Oral Problems by Remedies of Animal and of Human Origin]. / A FOG-ÉS SZÁJBETEGSÉGEK GYÓGYÍTÁSA ÁLLATI ÉS EMBERI TESTRÉSZEKBOL NYERT ORVOSSÁGOKKAL.

Use of matierials of animal or human origin in dentistry (and generally in medicine) these days is regarded as an unusal way of intervention. However in earlier times, different tissues, parts, products and organs of animals were frequently used in healing. Some of these methods were rooted in magical thinking. As analogical treatments--based on similarity or analogy--e.g. powder of horn or teeth of pike was used for the treatment of decayed teeth and different worms, maggots, veenies were applied against "toothworm". By difficult eruption of primary teeth bone marrow or brain mixed with cockridge-blood and goatmilk was a widely used medicine. Butter and honey were able to help the growing of teeth, as well. Parts of frog (fe: flippers) were also components of curing materials. Egg as the symbol of life was often an ingredient of medicaments. For the treatment of inflamed gum different animal materials were used, like chin and teeth of wolf, pike, crayfish, milk, honey, human saliva etc. Animal or human stools, mucks (containing enzymes) did one's bit in healing of oral and dental illnesses and were applied as fomentation or swathing. Placing a leech on the inflamed face was a common procedure in the past even as the use of earwax in lipnook. In our days tissues, parts or products of animals (or human beings) usually never allowed to get into contact with the body of patients. It's a much safer routine, at the same time however a precious traditional knowledge vanishes forever.

Management of proximal humeral fractures in the nineteenth century: an historical review of preradiographic sources.

BACKGROUND: The diagnosis and treatment of fractures of the proximal humerus have troubled patients and medical practitioners since antiquity. Preradiographic diagnosis relied on surface anatomy, pain localization, crepitus, and impaired function. During the nineteenth century, a more thorough understanding of the pathoanatomy and pathophysiology of proximal humeral fractures was obtained, and new methods of reduction and bandaging were developed. QUESTIONS/PURPOSES: I reviewed nineteenth-century principles of (1) diagnosis, (2) classification, (3) reduction, (4) bandaging, and (5) concepts of displacement in fractures of the proximal humerus. METHODS: A narrative review of nineteenth-century surgical texts is presented. Sources were identified by searching bibliographic databases, orthopaedic sourcebooks, textbooks in medical history, and a subsequent hand search. RESULTS: Substantial progress in understanding fractures of the proximal humerus is found in nineteenth-century textbooks. A rational approach to understanding fractures of the proximal humerus was made possible by an appreciation of the underlying functional anatomy and subsequent pathoanatomy. Thus, new principles of diagnosis, pathoanatomic classifications, modified methods of reduction, functional bandaging, and advanced concepts of displacement were proposed, challenging the classic management adhered to for more than 2000 years. CONCLUSIONS: The principles for modern pathoanatomic and pathophysiologic understanding of proximal humeral fractures and the principles for classification, nonsurgical treatment, and bandaging were established in the preradiographic era.

History of the treatment of scapula fractures.

The history of treatment of scapula fractures is closely connected with the history of the French surgery. Paré (Les œuvres d´Ambroise Paré, conseiller, et premier chirurgien du Roy, Gabriel Buon, Paris, p VCV, 1579), Petit (Traité des maladies des os. Tome second, Charles-Etienne Hochereau, Paris, pp 122­138, 1723), Du Verney (Traité des maladies des os. Tome I, de Burre, Paris, pp 220­231, 1751) and Desault (Œuvres chirurgicales, ou tableau de la doctrine et de la pratique dans le traitement des maladies externes par Xav. Bichat, Desault, Méquignon, Devilliers, Deroi, Paris, pp 98­106, 1798) were the first to point out the existence of these fractures. The first drawing of a scapula fracture was presented by Vogt (Dissertatio de ambarum scapularum dextroeque simul claviculae fractura rara, Dissertatione Universitae Vitembergensi, Wittenberg, 1799). This author was also the first to describe the scapula fracture associated with ipsilateral fracture of the clavicle. The first radiograph of scapula fracture (glenoid fossa fracture) was published by Struthers (Edinburgh Med J 4(3):147­149, 1910). The first internal fixation of scapula fracture using plate was done by Lambotte (1910) who was followed by Lane (The operative treatment of fractures, Medical Publishing Co, London, pp 99­101, 1914) and later by Lenormant (Sur l´ostéosynthèse dans certains fractures de l´omoplate Bulletins et mémoires de la Société de chirgie de Paris, pp 1501­1502, 1923), Dujarier (Fracture du col chirgical de l´omoplate. Ostéosynthèse par plaque en T. Bonne réduction. Bulletin et mémoires de la Société de chirurgie de Paris, pp 1492­1493, 1923) and Basset (Ostéosynthèse d´une fracture de l´omoplate. Bulletin et mémoires de la Société nationale de chirurgie. p 193, 1924). Dupont and Evrard (J Chir (Paris) 39:528­534, 1932) presented the first detailed description of the surgical approach along the lateral border of the scapula including two drawings. They were also the first to use the term "pillar of scapula". Judet (Acta Orthop Belg 30:673­678, 1964) advocated operative treatment of displaced scapula fractures and described extensile posterior approach. Based on the French school, AO/ASIF improved methods of internal fixation of these fractures.

An 18th century account of the treatment of burns and acute wounds that is still relevant today.

In 1766, a French physician wrote a treatise on wound management. Despite the lack of knowledge on physiology of wound healing and causes of infection, much of the clinical advice given in the text still holds true today.

Five millennia of wound care products--what is new? A literature review.

The first wound an wound treatments were described five millennia ago. Since then, various principles of wound care have been passed on from generation to generation. In contrast to large numbers of general technological inventions over the last 100 years, progress beyond ancient wound care practices is a recent phenomenon. It is essential to know the historical aspects of wound treatment (both successes and failures) in order to continue this progress and provide future direction. A survey of the literature shows that concepts such as "laudable pus" persisted for hundreds of years and that lasting discoveries and meaningful progress did not occur until grand-scale manufacturing and marketing started. Landmarks such as understanding the principles of asepsis/antisepsis, fundamental cellular research findings, knowledge about antibiotics/antimicrobials, moist wound healing, and the chemical and physical processes of wound healing have provided the foundation to guide major developments in wound management, including available evidence-based guidelines. Although research regarding interaction of basic wound management principles remains limited, the combined efforts of global research and clinical groups predict a bright future for improved wound management.