and largely as its result, comes a striking improvement in practice. And remember, that this is only the first fruit of a rich harvest for future time, in all countries, in peace and in war.
November 2d, of last year, a man was brought to the Chambers Street Hospital, in New York, with a pistol-shot wound in the abdomen. Under careful antiseptic precautions, and following the indications of Parkes, the abdomen was opened by Dr. Bull,[1] coil after coil of the intestines was drawn out, the bullet was found and removed, and seven wounds of the intestines were successively discovered and properly treated, and the patient made an uninterrupted recovery. A recovery, after so many wounds, any one of which would necessarily have been fatal under the old methods of treatment, shows that we have now entered upon a proper and successful method of treatment for such frightful accidents.
This is but one of the remarkable achievements of late years in abdominal surgery. The spleen has been removed, part of the stomach has been cut out for cancer, part of the bladder has been dissected away, the entire gall-bladder has been removed, and several inches of the intestine have been cut out, all with the most remarkable success. To all of these, experiments upon animals have either led the way, or have taught us better methods. To recite each in detail would occupy too much time, but one illustration I must not omit, for the improvement, produced by it and other experiments, affects every abdominal operation. When I was a student, the peritonæum was avoided by knife and needle wherever possible. After the death of his fourth case of ovariotomy, Mr. (now Sir Spencer) Wells,[2] in making the post-mortem, was led to believe that the then received treatment of the peritonæum was incorrect, and that he ought to bring its surfaces in contact in order to obtain secure union. Accordingly, instead of testing his ideas upon women, he experimented upon a few dogs, and found that his suspicions were correct. Since then it has been accepted as a cardinal point in all abdominal operations. Following this came improvements in the ligatures used, in the method of treating the pedicle, in the use of antiseptics, etc., all more or less the result of experiments upon animals, and what are the results? Taking successive hundreds of cases, Sir Spencer Wells's percentage of mortality has decreased steadily from thirty-four per cent to eleven per cent. In 1,000 operations he has saved 769 women from the grave and added a net gain of 17,880 years to human life, to say nothing of the happiness of the thousands related to them by ties of friendship and of blood—a proud boast indeed!
Since then, others have reduced the percentage of deaths after ovariotomy to three in the hundred; and Martin, of Berlin, has lost but one patient from blood-poisoning in his last 130 cases.
