The Robert Campbell Memorial Oration

DURING the last two years of the Great War your president and I had to make our way to work every day through wards crowded with wounded men, the great majority of them suffering from a streptococcus infection of their wounds. And in 1918 in those same wards we saw dozens of men die from the deadly streptococcus pneumonia that so frequently followed influenza dutring the epidemic. The end of the war came, and we had not got very far with the problem of controlling these infections. Sir Almroth Wright had shown that they were so common and so deadly because the streptococcus was able to propagate more freely in human blood and wound-exudates than any other microbe, but we had learned very little more than that. Nor for some years was there any very important advance. Recently things have happened, and I count it a great honour to have been asked by the trustees of the Robert Campbell Memorial Fund to tell you something about these recent happenings. It is a story that would have given great pleasure to Mr. Campbell. He was a progressive surgeon who started his professional career just at the time when surgeons were beginning to realize the importance of aseptic technique. That was a great triumph, but Robert Campbell must often have felt that it was a very incomplete triumph. Too often he must have been unable to do the operation he wished to do because the wound was infected. Very often he must have stood by a patient's bedside and watched the streptococcus take charge, he himself being unable to do anything to check it. Let us first consider the astonishing variety and the importance of these infections by haemolytic streptococci. I can touch upon only a few points-and very briefly. Puerperal infections by this microbe account for something like 1,20t deaths every year in England and Wales alone; and for every death there are four or five non-fatal illnesses. Apart from their importance to the race, these deaths are peculiarly tragic,. occurring as they do so often just at the crowning moment of a young woman's life, when her first child is born. The part played by this streptococcus in connection with war wounds has never, I think, been fully realized. Every large hospital became a hotbed of streptococcus infection, with the-result that something like ninety per cent. of wounds which were …