AN INTRODUCTORY LECTURE ON SURGERY. 
39 
A person receives a wound, the immediate effect of which is hemor- 
rhage. The bleeding is arrested ; next, inflammation arises. Coa- 
gulable lymph is thrown out and covers the surface, as is evinced 
by the adhesion to it of any lint that may have been applied. Sup- 
posing this lymph to have been removed, or to have failed in uniting 
the wound by what is called the first intention , the wound remain- 
ing open, and the inflammation continuing, pus or matter becomes 
secreted, and there now become visible, when the matter is wiped off, 
little processes of flesh we call granulations springing up, and, 
finally, the skin stretches or shoots out and covers them : and thus 
the wound is healed. It signifies not what the partis ; the process 
is the same in all. If there be any exception, it is in the case of 
bloodvessels. Knowing this, then, what does the surgeon do when 
called to a case of wound 1 He does all in his power to bring 
the edges of the wound together, and retain them in contact, in 
order that they may be glued and united. Suppose the surgeon 
be not called until twenty-four hours after the accident ; still, if he 
knows his business, he will bring the borders of the wound in con- 
tact, and, providing matter have not been formed, they will be 
glued by the adhesive inflammation. But if pus appear, then he 
encourages this, the suppurative process, by applying poultices; 
and when the granulations arise, he makes use of some unctuous 
substance to anoint and cover them, and all still does well. In 
the treatment of a wound, therefore, you have two objects in view : 
the first is to attempt union by adhesion ; the second, to encou- 
rage the granulative process. This applies to wounds either in or 
out of the body, unless there is any extraneous substance within 
them, or there is much contusion or bruise. As to ligatures, they 
are very seldom used — indeed, ought hardly ever to be adopted. 
The principles deducible from these three modes of practice are 
sure guides. When a man begins to theorize in surgery, he talks 
nonsense. 
The PRACTICE of surgery consists in the method of applying 
remedies. In the first place, neatness is required in their appli- 
cation ; this being a point your patients can judge of, although 
they know nothing about the modus operandi of your remedies. 
Adroitness is also requisite. And no surgeon should think of 
attempting the performance of an operation unless he feels he has 
perfect command of himself : his mind should be prepared so as to 
be ready to act on any emergency or unexpected occurrence that 
may arise. It is said, a surgeon should possess a lion’s heart, an 
eagle’s eye, and a lady’s hand. Let every thing that may be ne- 
cessary be prepared before you commence any operation. Ascer- 
tain whether your patient is the subject of any visceral or organic 
disease, or any constitutional disorder ; for, if he is, the opera- 
