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THE EVOLUTION OF SURGERY
7

privilege to be one of Mr. Southam's students. In those days we used as our guide in all surgical matters a text book which was not only by far the best of its day but which still in many respects presents a model of what a text book should be. All of us—even the least industrious—read the first two pages of this work, and there we found the following statement as to the point of evolution which surgery had then reached.

"Operative Surgery," says Erichsen, "like every other art, can only be carried to a certain definite point of excellence. There cannot always be fresh fields for conquest by the knife. There must be portions of the human frame that will ever remain sacred from its intrusion. That we have nearly, if not quite, reached these final limits there can be little question. To my mind it appears as if we had already reached something like finality in the mere manipulative art of surgery and in this direction the progress of modern surgery is nearly barred."

These words were written, or at least published, in 1884: the work of Lister was already known and his methods practised throughout the world: the new surgery had begun but few if any foresaw its rapid evolution. The very word "aseptic" was then not used of operative measures. Local anaesthesia was as far removed from our thoughts as was chloroform from those of Hippocrates. And when we seek for information upon the diseases of those organs whose surgical treatment now constitutes most of the work of our hospital we find an absolute and complete blank. Let us take but two examples—the familiar and almost friendly adenoids of our childhood and the appendicitis which brings so much of interest to all our lives and so much of profit to the surgeon: neither of these diseases