President's Address for the year 1887. xvii 



years ago was merely nominal, now supply over 12,000,000 

 tons per annum. This increased production has naturally 

 led to improved processes, so that now steel, which, not 

 many years since, was known only in small quantities as a 

 material for swords, knives and the like, is now used in 

 thousands of tons for rails, ships, and bridges. 



There is another and very diiFerent direction in which 

 human well-being has been enormously enhanced during 

 the present reign. Fifty years ago, ansesthetics were 

 unknown, and surgical operations were invested with a 

 degree of horror which now we find it difficult to realise. 

 The pain endured under even comparatively simple 

 operations was so fearful that the unhappy patient not 

 unfi:equently died from the shock, while in almost every 

 case recovery was seriously retarded. Consequently, surgical 

 relief was had recourse to in but an exceedingly limited 

 number of cases, and the desire to avoid unduly protracting 

 the intolerable sufferings of the patient, led to a hurried and 

 consequently imperfect style of operating, that most seriously 

 impaired the prospects of satisfactory recovery. 



Now all this is changed. By the aid of chloroform, ether, 

 nitrous oxide, and other anaesthetics, includinsj as the latest 

 and perhaps the most remarkable, the local anaesthetic, 

 cocaine, the patient is relieved of all pain, and the operation 

 can proceed with as much care and deliberation as the 

 dissection of a dead subject. Consequently, not only do we 

 employ surgical aid in thousands of cases where fifty years 

 ago it would have been regarded as utterly inapplicable, but 

 the result of each individual operation is immensely more 

 satisfactory than of old. The most serious surgical operation 

 is probably that for the removal of ovarian tumour, and this 

 is stated to have been first successfully accomplished in 

 London in 1842. For several years the mortality under 

 this operation was 50 per cent. Since then, however, owing 

 to use of ansethetics, and the adoption of special precautions 

 to secure perfect fireedom from germs of disease, the mortality 

 has been enormously reduced ; one leading British practi- 

 tioner having, it is stated, operated 251 times during the 



