ACHIEVEMENTS IN SURGERY.

It will not do to disparage the work of the ancients. The old world,

long since fallen below the horizon of the past, had races of men and

individuals who might well be compared with the greatest of to-day. In

a general way, the ancients were great as thinkers and weak as

scientists. They were great in the fine arts and weak in the practical

arts. This is true of the Hindus, the Egyptians, the Greeks, the

Romans, even of the Aztecs and the Peruvians.

The art work of these old peoples, whether in sculpture, painting or

poetry, surpassed, if it did not eclipse, corresponding periods of

modern times. In some of the practical arts the old races were

proficient. In architecture, which combines the æsthetic and

practical elements, the man of antiquity was at least the equal of the

man of the present. In one particular art--a sort of humanitarian

profession based on natural science and directed to the preservation

of life--the ancients had a measure of proficiency. This art was

surgery. The surgeon was even from the beginning, and he will no doubt

be even to the end.

The great advance which has been made in surgical science and practice

is shown in two ways: first, in a great increase of courage, by which

the surgeon has been led on to the performance of operations that were

hitherto considered rash, audacious or impossible; and secondly, by

the immunity which the surgeon has gained in the treatment of wounds

through the increased knowledge he possesses of putrefaction and the

means of preventing it. It were hard to say whether the surgeon's

increase of skill and courage in performing operations has equalled

his increased skill in the after treatment of wounds.

These improvements have all proceeded from scientific investigation.

They have come of the application of scientific methods to the

treatment of surgical diseases. With the investigations of Pasteur and

the development of the science of bacteriology, it was seen at a

glance how large an influence such investigation must have in the

work of the surgeon. The publication of Tyndall's "Essays on the

Floating Matter of the Air in Relation to Putrefaction and Infection,"

in 1881, gave a great impulse to the new practice; but that practice

had been already confirmed by the great and original work of Sir

Joseph Lister, an English surgeon who as early as 1860 had introduced

the antiseptic method of bandaging.

It is within the last forty years that the greatest marvels of modern

surgery have been performed. It would seem that no part of the human

body is now beyond the reach of surgical remedy. Almost every year has

witnessed some new and daring invasion of the fortress of life with a

view to saving it. Old opinions with respect to what parts of the

human economy are really vital have been abolished; and a new concept

of the relation of life to organism has prevailed.

Until recently it was supposed that the peritoneal cavity and the

organs contained therein, such as the stomach, the liver, the bowels,

etc., could not be entered by the surgeon without the certain result

of death. To do so at the present time is the daily experience in

almost every great hospital. The complexity of civilization has

inflicted all manner of hurts on the human body, and the malignity of

disease has spared no part. It was supposed that the cranial cavity

could not be entered or repaired without producing fatal results. It

was taken for granted that certain organs could not be touched, much

less treated capitally, without destroying the subject's life. But one

exploration has followed another and one successful adventure has been

succeeded by another still more successful until the surgeon's work is

at the present time performed within a sphere that was until recently

supposed to be entirely beyond his reach.

As to the liver, that great organ is freely examined and is treated

surgically with considerable freedom. This is true also of the

stomach, which until recently was supposed to be entirely beyond the

surgeon's touch. Within the last two decades sections of the stomach

have been made and parts of the organ removed. Not a few cases are

recorded in which subjects have fully recovered after the removal of a

part of the stomach. Sections of the intestinal canal have also been

made with entire success. Several inches of that organ have in some

cases been entirely removed, with the result of recovery! The spleen

has been many times removed; but it has been recently noted that a

decline in health and probably death at a not distant date generally

follow this operation.

The disease called appendicitis has either in our times become

wonderfully frequent or else the improved methods of diagnosis have

made us acquainted with what has long been one of the principal

maladies of mankind. The _appendix vermiformis_ seems to be a useless

remnant of anatomical structure transmitted to us from a lower animal

condition. At least such is the interpretation which scientists

generally give to this hurtful and dangerous tube-like blind channel

in connection with the bowels. That it becomes easily inflamed and is

the occasion of great loss of life can not be doubted. Its removal by

surgical operation is now regarded as a simple process which even the

unlearned surgeon, if he be careful and talented, may safely perform.

The surgical treatment of appendicitis has become so common as to

attract little or no notice from the profession. Even the country

neighborhood no longer regards such a piece of surgery as sensational.

The use of surgical means in the cure, that is the removal, of tumors,

both external and internal, has been greatly extended and perfected.

The surgeon now carries a quick eye for the tumor and a quick remedy

for it. In nearly all cases in which it has not become constitutional

he effects a speedy cure with the knife. The cancerous part is cut

away. It has been observed that as the recent mortality from

consumption has decreased cancerous diseases have become more

frequently fatal. Whether or not there be anything vicarious in the

action of these two great maladies we know not; but statistics show

that since the beginning of Pasteur's discoveries the one disease has

diminished and the other increased in almost a corresponding ratio.

Meanwhile, however, surgery has opposed itself not only to cancers but

to all kinds of tumors, until danger from these sores has been greatly

lessened. The removal of internal tumors such as the ovarian, is no

longer, except in complicated and neglected cases, a matter of serious

import. Such work is performed in almost every country town, and the

amount of human life thus rescued from impending death is very great.

The work of lithotomy is not any longer regarded with the dread which

formerly attended it. In fact, every kind of disease and injury which

in its own nature is subject to surgical remedy has been disarmed of

its terror. The eye and the ear and all of the more delicate organs

have become subject to repair and amendment to a degree that may well

excite wonder and gratify philanthropy.

But it is not only in the actual processes of surgery that this great

improvement in human art may be noted. The treatment of wounds with

respect to their cure by preserving them from bacterial and other

poisons has been so greatly improved that it is now regarded almost as

a crime to permit suppuration and other horrible processes which were

formerly supposed to be the necessary concomitants of healing. The

hospital, whether military or civil, was formerly a scene that might

well horrify and make sick a visitant. It was putrefaction everywhere.

It was stench and poisonous effluvia. The conditions were such as to

make sick if not destroy even those who were well. How then could the

injured sufferers escape?

It is one of the crowning glories of our time that no such scene now

exists in any civilized country. No such will ever exist again, unless

science should lose its grip on the human mind and the civilized life

subside into barbarism. The surgeon would now be held in ill-repute

that should permit to any considerable degree the processes of

putrefaction to take place in a wound of which he has had the care.

The introduction of antiseptic and aseptic methods has made him a

master in this respect. The skillful surgeon bids defiance to the

microbes that hover in swarming millions ravenous for admission to

every hurt done to the human body. To them a wound is a festival. To

them a sore is a royal banquet to which through the invisible realm a

proclamation goes forth, "Come ye! Come to the banquet which death is

preparing out of life!" All this the modern surgeon disappoints with a

smile and a wave of his hand. The invisible swarms of invading

animalculæ are swept back. Not a single bacterium can any longer enter

the most inviting wound while the surgeon stands ready with drawn

sword to defend the portals of life.

Great Religious Movements.

Notable Events of the Nineteenth Century Great Deeds of Men and Nations and the Progress of the World · 第 54 / 65 题