182 CONTEMPORARY SCIENCE 



head, the chest, the abdomen were ticketed "Noli me 

 tangere" except in the rare cases when operation was 

 absolutely unavoidable. 



I used to wonder why the students in "Rab and His 

 Friends" rushed to the amphitheater to get the best seats 

 to see Syme amputate a breast a so very common oper- 

 ation nowadays. But then I recalled the fact that even 

 in my student days, when anesthesia was the rule, capital 

 operations were rare. But in the pre-anesthetic days op- 

 erations were far rarer. In the five years preceding the 

 introduction of ether at the Massachusetts General Hos- 

 pital the entire staff only performed in all 184 operations 

 or three operations a month. When operations had be- 

 come not only painless, but safe, then the number per- 

 formed increased almost at a geometrical ratio, so that at 

 present the numbers even of single operations by single 

 surgeons e.g., of ovariotomies, appendectomies, goiters 

 mount into the thousands. What is still more gratify- 

 ing, the usual death rates of most capital operations in the 

 pre-Listerian days of one patient in four, in three, or in 

 two, or even two out of three ( !) have been changed to 

 one in twenty, thirty, fifty, or to even less than one life 

 lost in one hundred or even one in two hundred opera- 

 tions ! 



It is impressive most impressive to call the list of 

 only the most frequent and the most important of our 

 present operations. Were Mott, Bigelow or Pancoast 

 all of whom I remember well to come to life again they 

 would wonder whether we were not stark crazy. 



The following list I have made current e calamo on 

 the instant. 



Amputations are far less frequent. After a single bat- 

 tle in the Russian campaign (1812), Larrey, Napoleon's 

 great surgeon, performed not less than 200 amputations. 

 To-day of 200 similar cases, sometimes even with wounds 

 involving joints, the great majority would recover with- 

 out amputation. 



