316 SURGERY 



of surgery can be best illustrated by a reference to the statistics of 

 operations recorded in the Massachusetts General Hospital. Halsted 

 has given the figures for 10 years before and 10 years after the dis- 

 covery of anesthesia, which I quote. During the 10 years prior to the 

 employment of anesthetics, there were only 385 operations performed 

 in the Massachusetts General Hospital, or about 38 annually, or 

 about 3 each month, or less than 1 a week. In the 10 years after the 

 use of anesthetics began, and before the discovery of antiseptics, 

 there were 1893 operations, or say 189 annually, or about 15 every 

 month, or nearly 4 each week. If now the number of operations in 

 the same hospital during the past 10 years is considered, it is found 

 that they amount to 24,270, or about 2427 annually, 262 every 

 month, and about 50 each week, while of those performed in the 

 year of 1903, they number no less than 3109, or about 250 each 

 month, or about 65 each week. What a tremendous advance upon 

 the less than one operation each week of about half a century ago 

 to the 65 each week at the present time in one hospital alone. It 

 must be said, however, that this remarkable increase is largely due 

 to the introduction of antiseptics, as well as anesthetics, in surgical 

 practice. In other words, Hoffman has shown that the increase in 

 surgical operations during the past half-century has been more than 

 six times as great as the increase in hospital patients as determined 

 by the Massachusetts General Hospital. So we are led to the second 

 chief topic of this address. 



2. The Discovery and Practice of Antiseptics equal in Importance 

 that of Anesthetics, and contribute almost as largely to the Progress 

 and Development of Surgery during the Past Century. This discovery, 

 unlike that of anesthesia, belongs exclusively to no one nation. 

 Pasteur, in France, discovered that putrefaction is due to the pre- 

 sence of bacteria in the air. Lister, in Scotland, applied the dis- 

 covery to surgery. In Germany and in the United States a yet 

 further application of the technic was made. Antiseptics, therefore, 

 have been an evolution in which all well-progressed countries, 

 notably Great Britain, have taken a part. Lord Lister's discovery 

 will always stand as one of the great milestones in the advance of 

 surgical science. 



There are certain remarkable facts connected with the early 

 surgery of this country which clearly foreshadowed the introduction 

 of antiseptics. Absolute cleanliness was a characteristic feature of 

 Mott's surgery. His personal toilet and the cleansing of every 

 instrument before use indicated that he recognized perfect cleanli- 

 ness as a sine qua non to surgical success; also the employment of 

 animal ligatures in this country anticipated their general adoption 

 as an essential part of antiseptic technic. Dorsey, as early as 1844, 

 successfully ligatured large vessels with buckskin and catgut. 



