January 2, 19 13] 



NATURE 



503 



quent acquisition of extended and more definite patho- 

 logical knowledge, the field of greatest surgical activity 

 has been the abdomen — abdominal surgery, as we 

 now know it, has been created. Tens of thousands — 

 possibly millions — of human lives have been saved in 

 this field alone, and the amount of pain and discomfort 

 alleviated has been enormous. 



Surgeons of all countries have contributed to this 

 beneficent result, and have vied one with another in 

 restoring health and comfort to the community, thus 

 adding greatly to the economic prosperity of the 

 nations. 



Compound fractures, so fatal in pre-Listerian days, 

 were not only robbed of their fatality, but surgeons 

 became emboldened to make compound fractures for 

 the rectification of malformation of the limbs. 



Compound fractures, under the heading of osteo- 

 tomies, have been performed aseptically in thousands 

 — the bones healing aseptically. \ portion of bone 

 which has been fractured and displaced may be re- 

 moved, placed in aseptic solution, pared, rearranged, 

 and returned to its proper place in the body, where it 

 will live and grow, and become restored to its 

 functional use. Defects in the bone of one person 

 mav be made up by grafting on a portion of bone 

 removed from another. A transplanted bone may be 

 divided into little pieces, and a mosaic work of new- 

 bone may be placed in another animal to restore 

 defects. 



.^sepsis, along with better knowledge of the physics 

 of the pleura, has enabled surgeons to penetrate into 

 the lungs and to remove therefrom pathological pro- 

 ducts, with a gratifying amount of success. Portions 

 of lung have been removed, and several times the 

 whole of one lung has been successfully taken away — 

 the patients still continuing to enjoy life, working for 

 thjeir own living and one, at least, for that of his 

 family. 



Aseptic surgery has enabled operations upon the 

 brain to be safely undertaken, and brain surgery has 

 kept pace with the localisation of cerebral function. 

 Its further development rests with the increase of 

 precise data on that subject. Direct experiment on 

 the brains of lower animals furnished excellent data 

 on the localisation of the motor functions, but in- 

 formation as to the localisation of the higher inj-el- 

 lectual functions must be gathered by patient clinical 

 observation. 



The discerning eye and the discriminating sense 

 guiding the educated finger with its softness and 

 lightness of touch have, under asepsis, carried out 

 many operative procedures on diseased brains, where 

 the tangled skeins of that delicate fabric have been 

 unravelled. 



Considering the delicacv of the organ, and the fact 

 that in manv instances life has been sapped at the 

 governing centres of energy bv the pathological 

 lesions, operations on the brain have been very suc- 

 cessful, many of them veritably snatching the patient 

 from the brink. '■' 



The consummation of al,^.t■ acin^ / gical activity has 

 been attained bv the in* , -as rp'^joi aseptic practice, 

 surcrerv having been re-'.;?, eijiped since the introduc- 

 tion of Listerian principles and treatment. 



Personal Teaching and Demonstration versus Books. 



It is fashionable nowadays to decry university 

 teachers and professors, many regarding them as an 

 effete remnant of antiquity. It is contended that all 

 that is required is to issue a paper or a book and 

 allow the students to read at their own firesides 

 instead of compelling them to attend lectures ' and 

 demonstrations in a university. 



It is true that formerly the teaching extended only 



NO. 2253, VOL. 90] 



so far as the teacher's voice could carry, but now one 

 can write in one's own laboratory, and, if the message 

 be important, it will be borne to the limits of the 

 civilised world, and thus it is possible to instruct an 

 audience of unlimited size. 



There is, however, a difl'erence between teaching by 

 books and viva voce teaching and demonstration. 

 Some things may be explained by means of clear 

 writing and may be understood by correct reading, 

 but there are other things difficult of comprehension 

 in detail without the aid of practical demonstration. 

 More especially is this the case when one has not 

 the opportunitv of personal contact with the intro- 

 ducer or with one who has seen his practice and 

 followed his methods. No matter how well a state- 

 ment may be written, impressions are drawn from it 

 which differ according to the preparedness and pre- 

 vious experience of the mind of each individual 

 reader. Personal observation produces a much more 

 vivid impres^iion and generally corrects individual mis- 

 construction. 



As professor of surgery in Glasgow, Lister followed 

 the Scottish method, teaching the principles of sur- 

 gery in the University, and afterwards demonstrating 

 his methods in the wards of the infirmary. His lec- 

 tures in the University and his observations in the 

 wards were complementary to each other, and gave 

 a groundwork more thorough than could otherwise 

 have been obtained. Those who had been so taught 

 found his methods simple and easy of execution, and 

 were often astonished at seeing others less fortunate 

 falling into serious errors in their attempt to carry 

 out the antiseptic practice after reading Lister's 

 papers alone. 



There were many earnest men — professors of Con- 

 tinentrd imiversities, amongst others — who were well 

 qualified to read correctly what had been written, yet 

 who, having read, were not satisfied, but straightway 

 desired to be brought into personal contact with the 

 professor, in order that they might hear his teaching 

 from his ovv-n lips and sec the practice carried out by 

 his own hands. 



Prof. Saxtorph, of Copenhagen, was amongst the 

 first of the many distinguished visitors to the Glasgow 

 Royal Infirmarv to see Lister's practice and to study 

 his' methods. After a few days he remarked that the 

 seeing of the practice persuaded him of its feasibility, 

 and that it then seemed much easier than it did when 

 he had onlv read Hister's papers. So it was with 

 many others. 



Lister as a Scottisli and as a London Professor. 



Lister's teaching was more rapidly propagated 

 among the students he had in Scotland than among 

 the London students. The position which he occupied 

 as a Scottish professor aided in this, as it was different 

 from that held bv liim as professor of surgery in a 

 London hospital. 



In London in those days, the bulk of students 

 desired, naturally, to take the membership of the 

 College of Surgeons, and most teachers at that time 

 taught to the requirements of the Board of Examina- 

 tion, otherwise their prelections were not specially 

 sought after. In London, Lister was teaching a new 

 doctrine, not vet generally homologated, and his wards 

 were attended by few students compared with the 

 numbers that surrounded him in the Scottish univer- 

 sities. On the other hand. Lister had less time to 

 devote to the teaching of students, as London was 

 more accessible to foreign visitors, and many of his 

 davs were devoted to demonstrations for their benefit. 



.\s a Scottish professor, Lister's position offered the 

 greatest advantage for the dissemination of his doc- 

 trines. He could teach his own students what he 



