As the result of our ability to perform operations without pain, thanks
to anæsthesia, and our ability to perform operations without infection,
and, therefore, almost without danger, thanks to antisepsis, the range
of modern surgery has been enormously increased. Unless one has lived
through the old surgery and into the new he scarcely can appreciate
this widening of the field of operative surgery. Thirty years ago, in
consequence of the great danger of opening the head, the chest, or the
abdomen, or, in fact, of making an incision anywhere about the body,
the surgeon never dared to interfere until he was obliged to do so.
Hence, not only were many modern operations not even thought of, but in
obscure cases we had to wait until time and disease developed symptoms
and physical signs such that we were sure of our diagnosis, and then,
knowing that death would follow if we did not interfere, we ventured
to operate. Now we anticipate such a fatal termination, and in most
cases can avert it. In perhaps no class of cases has the benefit of
this immunity from infection and danger been shown than in the obscure
diseases of the brain and the abdomen. To-day, if we are uncertain as
to whether there is serious danger going on which, if unchecked, will
result in death, we deliberately open the one cavity or the other,
in order to find out the exact state of affairs. Supposing that the
mischief is trifling, or even that there is no mischief, we then know
how to deal with the symptoms which have been puzzling us. So far as
the exploratory operation is concerned, the patient recovers from it
in a short time, and, meantime, perhaps has also been cured of the
symptoms which were before so ill understood. If any serious disease
is found, in the majority of cases we can cope with it successfully.
Before the days of antisepsis and anæsthesia the field of operation was
greatly restricted, and practically the removal of tumors, amputations,
and a few other operations were all that were done. Now all the then
inaccessible organs are attacked with an intrepidity born of an
assurance of safety. Recovery usually sets the seal of approval on
the judgment of the surgeon. Thirty years ago, taking all operations
together, fully one-third of our patients died, many of them often from
slight operations which were followed by infection. To-day, including
even the far more grave operations which are now done, the general
mortality will scarcely exceed five per cent., and many surgeons are
able, in a series of several hundred operations, to save ninety-seven
out of every hundred patients!