BEFORE AND AFTER LISTER 183 



Formal ligations are far fewer. 



External tumors of any size are now removed from 

 all parts of the body without fear of erysipelas, which so 

 worried Sir Astley Cooper before he operated on the king 

 for a simple wen. The mere fact that any tumor is in- 

 ternal inside the head, the chest, the abdomen, or the 

 pelvis has practically no influence on the decision 

 whether it should or should not be removed. 



Trephining even for exploration is frequent and per 

 se involves slight danger, as in decompression. 



Martin, of Berlin, has done over 1,000 ovariotomies, 

 with a mortality of less than 2 per cent., and the Mayos 

 from 1905 to 1914, inclusive (the only period for which 

 I had the annual reports at hand), reported 609 cases 

 with 5 deaths, or eight- tenths of i per cent. Colostomy 

 and enterostomy are frequent. Many thousands of her- 

 nias have been cured by operation, with practically no 

 mortality ; and if done early in strangulation, with slight 

 mortality. 



The new surgery of the head attacks tumors even of 

 the hypophysis, punctures the lateral and the fourth ven- 

 tricles with impunity, successfully extracts foreign bodies 

 and in some cases relieves epilepsy and mental derange- 

 ments. 



In the neck simple goiters even of large size are re- 

 moved, with a mortality of I and 2 per cent. ; and laryn- 

 gectomy is common. 



In the chest, that very citadel of life, the heart itself 

 is sutured for gunshot and stab wounds, saving one life 

 out of two; the esophagus is attacked for cancer and the 

 removal of foreign bodies ; large portions of the chest 

 wall are removed for old empyemas, and the lungs can 

 now be operated on at leisure, thanks to insufflation anes- 

 thesia. 



In the abdomen, the various operations on the stomach, 

 even to its total extirpation, are too many to name in 

 detail; and with a success that is truly marvellous. We 



