THE TEACHING OF PRACTICAL SURGERY. 
871 
into yet closer relation to the living object of his study. 
In reality it belongs rather to the domain of surgical or 
regional anatomy, the importance of teaching which should in 
no wise be underestimated. It gives the student a training in 
surgical anatomy essential to surgical procedure, he learns the 
location and relations of parts or organs, and observes the post¬ 
mortem form, volume and texture of parts from which he may 
draw valuable conclusions regarding their character in the liv¬ 
ing world. 
This teaching, call it surgical anatomy, clinical or operative 
surgery, should be well and extensively taught, each student 
being required to demonstrate his anatomical knowledge of the 
parts concerned in the more common of our surgical operations, 
repeating again and again as often as may be necessary the 
imitation of each operation until familiar with it. 
An especially commendable course of this kind is that prac¬ 
ticed at the University of Pennsylvania, under the able direc¬ 
tion of Professor Adams. His course consists of ioo operations, 
many of which are repetitions, thus reducing the actual separate 
operations to the neighborhood of 50, nearly all of which are 
performed on the cadaver. His list includes a very large propor¬ 
tion of the classifiable surgical operations, omitting some which 
other teachers would insert, including a few which some would 
incline to omit. 
An especially commendable feature of his plan is to have 
the operations carried out in as good imitation as practicable of 
the real procedure, and as quickly as possible after destroying 
the animal by bleeding or pithing. The plan is.moreover in¬ 
expensive, and the time required of the student for carrying it 
out is comparatively brief. 
It has very evident shortcomings, it fails to familiarize the 
student with the character and behavior of living parts under 
suro-ical interference ; he learns neither to avoid nor control 
haemorrhage, to guard against the contractions of muscles, to 
avoid the evil consequences of the struggles of the patient, and 
even fails to learn the form and exact location of some organs 
