Page:The Evolution of Surgery.djvu/13

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9
The Evolution of Surgery.

about one-fourth of all surgical in-patients were operated upon, while in the second the number was nearly threefourths. In spite however of this great increase in the amount of work the percentage of deaths after operation had fallen from about 10½ to about 8½, these numbers including deaths from all causes whatever and not by any means only those due to operation, which, could we define them, would be far fewer. Thus in 1883 we find that nearly one-fifth of the deaths after operation were due to infective conditions which are now so far preventable that we cannot possibly attribute more than one per cent, of the present mortality to such causes.

It is, however, when we turn to special classes of disease that we find still more striking evidence of change. In 1883 the abdomen was opened with fear and trembling, and abdominal operations were performed only in the hope of averting directly threatened death, while they were rarely if ever resorted to in order to relieve suffering, to restore true health, or to prevent future catastrophes. Thus in the year of my house surgeoncy we find but 12 operations on the abdomen of which seven, or more than half, died, while in 1908 we find nearly 500 of such operations with a mortality of about 11 per cent., the mortality including deaths from such conditions as hopeless cancers, injuries and the like, and the large number due to too long delay in securing treatment. When you reflect that in one hospital alone this means an average of between one and two persons relieved daily from diseases of the abdomen, which would otherwise have been almost certainly either fatal or a cause of lifelong disablement, you will appreciate what such figures mean.

I will not weary you by tracing similarly the surgery of all regions, but I may tell you briefly a few other facts of this class. Many of the diseases of the kidney are very fatal or very painful, or both. In 1883, three