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resolved to give it a trial in general surgery. At that time, as assistant surgeon in the Royal Infirmary of Edinburgh, I had charge of the Lock Hospital; and one of the patients having an atheromatous tumour of the scalp, I removed it and brought the edges of the skin together with a silver stitch. No vessel required ligature, and the wound healed without suppuration. As the suture created no disturbance, I left it in situ for about ten days, when I took the patient over to Mr. Syme and showed him the skin about the wire perfectly pale and natural in appearance without a trace of discharge, whereas a silk stitch would within four days have infallibly caused suppuration, with surrounding redness. Mr. Syme at once recognised the importance of the facts, and from that day forward the silver suture was used for all wounds in the clinical wards, until, some years later, antiseptic measures caused it to give place to the more convenient and no longer hurtful silk.
In thinking over this striking difference between the effects of the two kinds of suture, it seemed to me clear that it depended on the silk imbibing blood and serum, which, undergoing decomposition in its interstices, grew more irritating the longer the process continued; whereas the metal gave no hold to the organic liquids, which were shed unaltered as fast as they were effused. From these and other analogous considerations, I taught my class at that time that decomposition of the organic liquids was the essential cause of suppuration.
