Page:The Evolution of Surgery.djvu/21

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The Evolution of Surgery.

show how the mortality from strangulated hernia had been diminished in a short twelve years, not only by improvements in the method of operating but also by an increased appreciation by the profession and the public of the necessity for promptitude. Not many years ago the patient "submitted to operation," as it was called, only after long delay, after many conferences with friends and with those surgeons who were almost regarded as foes, and after a prolonged trial of methods differing little from those of the days of Galen. To-day there is little question of "submitting to operation"; it is now often more difficult for the surgeon to discourage the useless than to urge the necessary. The laity has learnt what can be done and the consequent demand for the surgeon's service has tended ever to increase the value and the readiness of that service.

And thus we now attack nearly all the strongholds of disease while new triumphs and new conquests follow with bewildering rapidity. In 1876 Lawson Tait first removed some stones from the gall bladder and the daring operation was regarded as one which might be occasionally adopted: in 1909 Mayo Robson had collected 3,000 of such operations performed by three surgeons alone, and with a mortality of less than 2 per cent. Some 20 years ago the operation of gastroenterostomy was introduced to surgery: it is now one of the commonest of remedial measures and many thousands have been rescued by it from the slow martyrdom of so-called dyspepsia. In 1896, an Italian surgeon. Farina, made the first attempt to suture a wound of the heart itself and in 1909 Vaughan collects 150 cases with 35 per cent, saved from certain death. Still more recently we have seen successful operations for the diseases of the heart, while an ingenious device now makes it possible to open the chest with the surrounding atmospheric pressure reduced to that in the