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JAMA 100 Years Ago
April 6, 2005


JAMA. 2005;293(13):1566. doi:10.1001/jama.293.13.1566-c

During the past, one of the most unexplainable facts in surgery has been the occurrence of infection in surgical wounds, after all reasonable precautions had been taken to prevent it. The experiments of Flügge show the possibility of the dissemination of tuberculosis germs through droplets of sputum, and the experiments of Alice Hamilton and of Mendez de Leon, furnish an explanation of this possibility. It appears from Dr. Hamilton’s studies and experiments, published in this issue of THE JOURNAL, that streptococci are found in the majority of normal mouths, and that they are expelled to varying distances in the acts of coughing, breathing and even talking. The fact that no absolute rule as to the number of germs or distance to which they are expelled can be laid down adds the element of uncertainty to this danger, and renders it all the more difficult to guard against. Mysterious epidemics of septic infection are thus explainable, as well as the aggravation of such disorders as scarlatina. The aggravation of the virulence of germs by successive cultivations on suitable media add decidedly to the probabilities of evil from this source. Aseptic surgery and medicine are constantly meeting new problems, and these studies throw light on much that has been obscure in the past. The value of the mouth guard for operating surgeons and the necessity of isolation of septic cases are also clearly demonstrated.

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