JOHN B. MUBPHY 349 will never come within reach of surgeons generally. They say that the operations are technically difficult, that they re- quire a degree of asepsis not attainable in country hospitals, and that the after treatment is too complicated and too pro- longed to make it possible for the general run of surgeons to enter this field. In this the objectors lose sight of the trend of the times. The characteristic contribution of Dr. Murphy to surgery has been a simplicity of method that brings opera- tive procedure within the range of the country surgeon's technical skill. As a result, the surgeon in the smaller com- munity is growing more skilful and the standards of asepsis of the small town hospitals are becoming higher year by year. The massage and manipulation required in the after care will be given by men trained for it as the demand for their service grows. The first campaign conducted by Dr. Murphy was for early operation in appendicitis. To operate in appendicitis could not even be proposed until the preliminary work in pathology v and bacteriology had been done. It could not be advised un- til the development of asepsis had made operations on the abdominal organs possible. After this stage had been reached Dr. Murphy saw that the key to the appendicitis situation was early operation. He threw his dominating personaUty into a campaign of education addressed to the profession and to the laity as well. As the result of that campaign the people are well informed. As to the significance of the symptoms of ap- pendicitis, the physicians are accustomed to early diagnosis, and early operation is the rule. While he contributed to our knowledge of the pathology of appendicitis and improved the technique of operation on the appendix, his great service lay in changing the popular cus- tom. Twenty-five years ago the man with an intestinal per- foration was in a hopeless situation. The operation used to require from one to four hours for its performance. The tech- nical skill required for such an operation was beyond any ex- cept the best trained surgeons. As such operations are those of emergency it followed that a large portion of those having wounds of the intestines, strangulations with gangrene, in-
