848 



SCIENCE 



[N. S. Vol. XLI. No. 1067 



found four dead soldiers and three propped against 

 the wall, their features all changed, and they 

 neither saw, heard nor spake, and their clothes 

 were still smouldering where the gun-powder had 

 burnt them. As I was looking at them with pity 

 there came an old soldier who asked me if there 

 was any way to cure them. I said no, and then he 

 went up to them and cut their throats gently and 

 without ill will toward them.9 



Leaping over three and a lialf centuries 

 of only moderate progress, let us next con- 

 sider the state of surgery a hundred years 

 ago. No better representative perhaps 

 could be chosen than John Bell, the pro- 

 fessor of surgery in Edinburgh, whose 

 "Discourses on the Nature and Cure of 

 "Wounds" had reached a third edition in 

 1812, and his "Principles of Surgery" a 

 new edition in 1826, to which his brother, 

 Sir Charles Bell, also contributed. 



In the former he states that tents or 

 setons were much in use and the surgeons 

 "were quite delighted with seeing prodigi- 

 ous quantities of matter spouting out when 

 they drew their spigot away" (p. 299). 



As to abdominal wounds he says: 



Having put it down as a prognostic, which is but 

 too well confirmed, by much melancholy experi- 

 ence, that wounds of the belly are mortal, there 

 is no reason why we should, in recording our 

 cases, take any note of a man having died after 

 such a wound. Death from such a wound is a 

 daily and expected occurrence and, therefore, is 

 not marked; but if we find that a man has es- 

 caped, are we not to record every such escape? 

 (p. 313). 



Per contra, to-day recovery has been 

 achieved after 19 wounds of the abdominal 

 viscera ! 



He considers wounds of the joints also 

 as mortal, and amputations even in the most 

 favorable circumstances did not heal under 

 four, five or six months! 



In his "Principles of Surgery"^" he 



9 Paget 's "Ambroise Par6," p. 31. 



1" John Bell 's ' ' Principles of Surgery, ' ' new 

 edition, with comments by Charles Bell, London, 

 1826, p. 86. 



pictures the wards of a hospital as follows : 

 You look 



upon limbs variously wounded, but all of them 

 lying out, swollen, suppurating, fistulous, rotting 

 in their own filth, having carious bones, bleeding 

 arteries and a profusion of matter; the patients 

 exhausted in the meanwhile, with diarrhea, fever 

 and pain. 



Again he refers to a wounded limb as 

 "soaking in suppuration" and again, of its 

 "lying in a slush of matter and foul 

 poultices. ' ' 



He relates the case of an officer under 

 the care of Guerin, a French surgeon. 

 He was wounded by a ball which had 

 broken the fifth rib twice and traversed the 

 entire chest. After dilating the wounds, 

 Guerin introduced a seton ["a great strap 

 of coarse linen"], 



which, of course, went across the breast as a bow- 

 string crosses a bow, and this seton he continued 

 to draw with a perseverance which is truly won- 

 derful from the first day to the thirty-eighth day 

 of the wound; during all of which time the pa- 

 tient's sufferings were dreadful (p. 458). 



In fifteen days the patient was bled twenty- 

 six times. After the removal on the thirty- 

 third day of a splinter of bone, which had 

 been imbedded in the lung, the patient, 

 strange to say, recovered both from the 

 wound and from the surgeon. It is not to 

 be wondered at that Bell condemns such 

 treatment. But it existed in the practise 

 of reputable surgeons. 



Erysipelas, tetanus, pyemia, septicemia 

 were rife. Hospital gangrene was endemic 

 in many if not most hospitals, due to inevi- 

 table infection in practically every wound. 

 Veritable epidemics were frequent. Is it 

 any wonder that it had always been present 

 for nearly two hundred years in the Hotel 

 Dieu in Paris when there were often from 

 two to six patients (and such patients!) in 

 one bed ? Passing along the streets of Paris 

 even during the Crimean "War^^ "one could 



11 Wrench's "Life of Lord Lister," p. 239. 



