PROGRESS OF MEDICINE IN THE NINETEENTH CENTURY. 639 



the hiro'c intestino on the rig'ht .side of the lower part of the alxlomen, 

 intiainination of which, known as appendicitis, cau.ses excrutiating- pain 

 and often produces internal abscesses and death. An operation for 

 the removal of such a diseased appendix is now common, and, in most 

 cases, successful. The operation for the removal of calculus or stone 

 from the urinary bladder dates from over two thousand five hundred 

 years ago, and no one knows who first performed it. Within the last 

 century it has been largely superseded b}^ an operation which crushes 

 the stone to powder within the bladder, and removes this powder with- 

 out the use of the knife. The removal of calculi from the kidney, 

 or from the gall bladder, and the removal of a diseased kidnev are new 

 operations, made possible ])y improved means of diagnosis, anesthesia, 

 and antisepsis. Wounds of the intestines were formerly thought to 

 be almost necessarily fatal, and nothing was done for them except to 

 stupef}" the patient with opium. Now, in such cases, the al)domen is 

 opened, the lacerations of the bowel are closed, the effused blood and 

 other matters are removed, and in man}^ cases life has thus ])een pre- 

 served. 



By increase of knowledge of the anatomy of the brain, and of the 

 distri])ution of nerves connected with it. it has l)ecome possible in a 

 certain number of cases to determine what part of the l)rain is sufl'er- 

 ing from irritation or pressure, and to operate for the removal of the 

 tumor or other sul)stance causing the troul)le, with considerable hope 

 of giving permanent relief. A branch of surger}' wdiich has devel- 

 oped into an important specialty during the last century is that known 

 as plastic and orthopsedic surgery. The replacing of a lost nose by 

 engrafting other tissue in its place is a very old triumph of surgical 

 art, but operations of this kind have been greatly extended and per- 

 fected within the last hundred years, and much can now be done to 

 mitigate the deformity and weakness due to club feet, band}' legs, 

 contracted joints, etc., which formerly were considered to be beyond 

 remedy. 



Many of the diseases peculiar to women have been deprived of much 

 of their terrors within a hundred years. In 1800 for every thousand 

 children born, from ten to twenty mothers died. Puerperal fever 

 occurred in epidemics, following certain physicians or nurses, but 

 nothing was known as to its causes or nature. To-day puerperal fever 

 is almost unknown in the hospitals or in the practice of a skilled ph}'- 

 sician. The death rate of mothers is less than five per thousand births, 

 and the mechanical obstructions which a century ago would have 

 almost certainly brought about the death of both mother and child 

 are now so dealt with that more than half of both mothers and children 

 are saved. 



The study of the diseases of the eye has greatly developed another 

 specialty during the century, viz, ophthalmology. The investigations 



