MEDICINE 165 



MEDICINE ' 



In the following survey of the advancement of the art and science of medicine and 

 surgery during 1910-12 it is only possible to note the outstanding facts of progress, and 

 no attempt is made to trace out the innumerable observations which preceded each dis- 

 covery and each theory. An excellent account of medicine and surgery, from year to 

 year, is to be found in the Medical Annual (John Wright & Sons, Bristol). 



The deaths of Florence Nightingale, on August 13, 1910, and of Lord Lister on 

 February 10, 1912, remind us of the very origins of modern surgery and modern nursing. 

 Long ago, they had finished the work of their lives, and had given it into other hands to 

 be carried further; and death came to them as a quiet release from old age. They won 

 the gratitude and the reverence of mankind; and it is no light honour to the medical 

 profession to have these two names in its calendar. To them must be added the name 

 of Robert Koch, who died on May 27, 1910. We associate his name so closely with his 

 later studies of tubercle, malaria, and sleeping-sickness, that we are apt to forget his 

 earlier study of the infective diseases of wounds, his discovery of gelatin-media for the 

 growth of bacteria in pure culture, and his use of differential stains in bacteriology. He 

 advanced the new learning in Germany, as Lister advanced it in England. 



Next to Lister's name, we may fitly notice some of the most recent developments of 

 operative surgery. Many operations have been performed, with very satisfactory re- 

 sults, for the relief of intra-cranial pressure, e.g. from intra-cerebral growths; or for the 

 relief of intra-spinal pressure, e.g. in chronic spinal meningitis. Division of the posterior 

 nerve-roots has been performed, with success, in some cases of spastic paralysis. 2 In 

 another field of surgery, Alexis Carrel's work, at the Rockefeller Institute, on the direct 

 suture of arteries, is leading to good results in practice: and his study of the transplanta- 

 tion of organs and the aseptic storage of organs and of tissues 3 is of so great importance 

 that one of the Nobel prizes for 1912 was rightly awarded to him. In the surgery of the 

 heart, there is by this time a large number of operations, under conditions of emergency, 

 for the suture of stab-wounds. G. T. Vaughan, 4 in 1909, was able to collect records of 

 150 such cases, with 35 per cent recoveries: and more cases have been published since. 



But these and other achievements of operative surgery, made possible by Lister's 

 work, are but a small part of the medical history of the last few years. In physiology, 

 in general medicine, and in pathology, the multitude of new facts and methods is so 

 great that it hardly gives itself to any proper arrangement. Nothing more can be done 

 than to note, in the order of the alphabet, some results which have been of especial in- 

 terest alike in science and in practice. 



Anthrax. For some years, Sclavo's serum has been used for the treatment of 

 anthrax in man: and we now have an authoritative statement of the value of this treat- 

 ment, in the sixth Annual Report of the Anthrax Investigation Board for Bradford 

 and District, whose medical adviser is Dr. Eurich (Brit. Med. Journ., April 20, 1912). 

 The authority of Dr. Eurich on all questions relating to anthrax may safely be called 

 final. The Report gives evidence that Sclavo's serum is useful in cases of infection not 

 only through the skin, but also through the lungs (wool-sorters' disease). 



Appendicitis. Of many theories to account for the great frequency of this disease, 

 none has yet come to general acceptance. The frequency of appendicitis may be 

 judged by the fact that five cases were admitted during one night into one of the Lon- 

 don hospitals, all of them in need of immediate operation. The evidence is by this time 

 almost irresistible, that delay in operation, reckoned over large groups of cases, is not 

 advisable. Thus, among 687 operation-cases in a hospital in New York, 5 20 underwent 



1 See E. B. xviii, 41 el seq., and xxvi, 125 et seq., with allied articles enumerated under 

 ""Medical Science" in E. B. Index Volume, pp. 937, 938. 



2 See, inter alia, the paper by Prof. Foerster, of Breslau, Proc. Roy. Soc. Med., July 1911. 



3 See "The Preservation of Tissues, and its Applications in Surgery." By Alexis Carrel, 

 M.D., Journ. Amer. Med. Ass., lix, 7, August 7, 1912. 



4 G. T. Vaughan, Journ. Amer. Med. Ass., February 6, 1909. 

 6 McWilliams, Annals of Surgery, June 1910. 



