The Sun.
London, England, 1858-08-03 00:00:00

SCIENCE

Professor MILLER gave a most interesting sketch of the
vast progress of surgical science in later times, and dwelt
with great effect upon the achievements of conservativei sur-
gery. In one respect, however, he remarked the knife is busier
now than before—namely, in removing diseased portions of
a part in order to preserve the whole. Operative surgery,
mutilating or destructive, we desire to curb; and as our
art truly advances, this deparment of it will be found within
still narrowing limits ; but operative surgery, which is
conservative, is widening its field of work, and with the
happiest results. In surgery, as in medicine, and perhaps
more especially, we have to guard against a common error
in believing that progress and 'amendment are necessarily
connected with the discovery of what is striking and new.
The flash of novelty is one thing—the steady light of progress
is quite another thing. The foremost wan is not he who
jerks himself into the front by some royal road or short cut,
but he who has come by the old ways, and uses these
as his basis of operations in advance. To he safe we must
occupy a space between two extremes—not blind to inno-
vation on the one hand, not blinded by innovation on the
other. The rule of conduct is plain and infallible—" Prove
all things; hold fast that which is'good." (Cheers.) Pro-
fessor Miller then referred to one or two points of recent
interest. With regard to the painless operation, lie said—
In the ease of children the amesthetie use of chloroform is
almost all that could be desired. Its effect is both rapid
and easy. It annihilates an agony which etherwise would
have proved a sad penance to both surgeon and patient ;
and we are seldom troubled with anxiety or alarm in its

working. Formerly one of the most painfal tasks con-
nected with our art was the diagnosis of injuries and
performance of operations on patients of tender years;
and sometimes the symptales of our common nature

_ .
may have temptel to a hasty and imperfect execu-
tion of the task, out of mere compassion to the writhing
sufferer. Now, the utmost deliberation and care are in all
cases within our reach ; the patient passionless ; and the
risk of casualty notoriously small. In the case of adults, I
desire to express my own conviction that a complete anms-
thesis by inhalation ought to be had recourse to only in
obedience to the requirement of stern necessity. My belief
is unqualified in the law of tolerance here. If the circum-
stances are such as to demand the remedial agent, that may
be readily administered, in the expectation that the system
will not suffer permanent damage in its use, and that the
ultimate result will be in no respect untoward. But if the
circumstances of the case be not so imperative, then I have
no confidence in the anmsthelic, and will fear a casualty at
every turn. This is no fancy or superstition. It is the
working out of a law of Nature which permeates the
whole range. " Quod necessarium, tutum." The thera-
peutic objects of the anaesthetic agent I take to be—the
abrogation of intense and exhausting pain, the diminution
of shcck, and the relaxation of muscular action; the last,
perhaps not the least important. In any formidable sur-
gical procedure in which the attainment of one or all of
these objects seems highly expedient, if not absolutely neces-
sary—as in amputations, lithotomy, dislccations, hernia,
&c., I would not hesitate to anaesthetise ; but in any minor
procedure in which pain or risk of shock is inconsiderable,
or in which muscular relaxation and absolute impassivity
are not required, I would be slow to humour the patient's
fancy, or quiet his unnecessary alarm at the expense of
running counter to the law of tolerance, and so incurring
ri-k of serious casualty. It becomes me to take this oppor-
tunity of stating that when chloroform was first brought
into use here, I was a great enthusiast in its praise.
I esteemed it to be as safe and manageable as it was bene-
ficial, and thought that it could hardly be used too often or
too freely. I committed these thoughts to written words,
and, as I wrote, my pen warmed with an honest enthusiasm.
But subsequent events have chastened and subdued my
tone ; and my present " surgical experience of chloroform"
amounts to this—never to withhold its use when that use
seems to be imperatively required, and never to sanction its
use unless this seems to be absolutely demanded, always con-
ducting its administration with the utmost prudence and
caution, so as to avoid those terrible results which error or
excess, even under the protection of an existing tolerance,
may not fail to produce, and from which, as experience has
too fully shown, even faultless administration is not altoge-
ther free. Into the question as to whether ether or chloro-
form be the safer antesthetic, Ido not enter. Both are im-
perfect; and ere long an agent superior to both may pro-
bably be discovered.

At half-past eight p.m. a convemazione was held at the
College of Physicians. The spacious rooms were overflow-
ing. Tim excellence of the entertainment both to mind and
body gave universal satisfaction. In the course of ;the
evening Dr. G. Wilson, professor of technology in the uni-
versity, delivered a brilliant lecture upon the " Indestructi-
bility of Force." Force might be transmuted or trans-
ferred, or lost, so far as its use and application were
concerned, but it was never lost in the sense of its being
annihilated. He illustrated his remarks by a comprehen-
sive analysis of the investigations into the laws of beat,
electricity, &c., from the period of Rumford and Davy down
to the time of Herschel!, Faraday, Joule, and W. H.
Thompson. The general conclusion from these inquiries
being that terrestrial force was almost entirely derived from
solar heat; the last-named philosopher having carried his
investigations so far as even to compute how long that
source of power might last.

JULY 31.
The Medical Missionary Society and a numerous party
of the British Medical Association breakfasted together at
eight a.m. At 11 o'clock the association reassembled.
ADDRESS ON THE PRESENT STATE OF MIDWIFERY.
Dr. SnarsoN delivered an address on " The Progress of
Midwifery." He began by describing the careers of three
neighbouring country doctors established in Hamilton and
Lanark 130 years ago—viz., Dr. William Cullen, Dr. Wil-
liam Hunter, and Dr. Smellie, and by showing that the two
last were the founders of the modern school of British Mid-
wiferyt He proceeded to trace in rapid succession the
various advances in the science and art of obstetric medicine
and surgery from Smellie's day to our own, and specially
insisted on the fact that gradually from an increased know-
ledge of obstetric physiology there was less and less meddle-
some interference in the way of obstetric practice. He dwelt
at some length on the history of the introduction of anmst he-
tics into midwifery. If their use was irreligious, then
modern agriculture was irreligious too, because it made
use of many implements and appliances to diminish or do
away with that curse which permitted man to till the
ground "in the sweat of his brow" alone. In this way,
irreligion was the characteristic of all the studies of the
physician that tended to annul those pains which the
curse entailed, and to avert that death which was its
peculiar sting. And in this way, irreligion must be charged
against divines, whose earnest life-long labours were
directed towards the abolition of sin, and so to the abroga-
tion of the primeval curse. Nor was the practice more

unnatural or more an unnecessary interference with pro-
videntially arranged functions, as some had averred, than,
were any of the practices of civilisation, for they ell
appeared at first unnatural, and they all interfered
with functions providentially arranged. Pain in labour was
no more " salutary and conservative" than pain in other
circumstances; in fact, it could most easily be statistically
shown here to be dangerous and destructive. The mission
of the physician was twofold—to preserve human life, and to
alleviate human suffering, and be who in any case omitted
to do the latter, failed in his duty to his patient, and wil-
lingly descended from the high platform of active philan-
thropy on which members of the medical profession should
ever stand. No one dared refuse his skill to remove other
pains; why did any one hesitate to remove the pains of la-
bour? The probability was, that with this as with other
beneficent innovations, the reform in practice from which
the profession held back would be forced on them in the end
by their suffering patients, in the same way as the punish-
ments of crime had been mitigated at the unanimous de-
mand of a people, and in opposition to the stern re_
sistance of chancellors and lawyers who thought the Bri
tish constitution must have gone to ruin if a petty

ieft were punished by a milder means than the

hangman's rope; and as, but for the laity, the clergy might
still be firing the faggot round the heretic's stake. Some
of the medical objections—such as that anaesthesia in labour
would lead to idiotcy, puerperal fever, mania, and compli-
cations of all kinds, experience had shown to bo utterly
unfounded; and as for the convulsions which chloroform
was to have produced, chloroform had proved itself the
most certain remedy for the disease. The dread that it
would often prove fatal bad turned out to be unfounded as
far as regarded its administration in labour, for not one
fatal case had ,been reported from among the many thou-
sands in which it had been used ; and in some of those
surgical cases where anaesthesia had been blamed for the

fatal issue, the blame might have been unjust, seeing
that patients had not unfrequently died on the operating
table suddenly, and without a sign, to whom no anaesthetic
had been administered. That chloroform would cause
death, he (Dr. Simpson) had shown in his earliest paper on
the subject; but so could opium, Epsom salts, and almost
every other drug when used in large full doses. It had now
become a domestic remedy with many families in Scot-
land ; and with due care it might be used with as much
confidence as most other drugs in the pharmacopoeia.
Many practitioners who had at first opposed it had now
come to employ it in natural labour, either from the con-
viction of its utility or on the compulsion of their patients.
After making some observations on the triode of its admi-
nistration in labour, Dr. Simpson concluded his address by
laying down a few rules to be observed in using it, insist-
ing particularly on this, that the vapour should be exhibited
only during a pain, and should be removed entirely during
the intervals.

During the delivery of his address Professor Simpson
was repeatedly interrupted by bursts of applause. From
the strictly professional character of some parts of it our
analysis is necessarily imperfect.
A vote of thanks was given to Dr. Simpson on the
smTortiD.
motion
of Mr. I. B. BROWN of London, seconded by Mr.
MAN of Guildford.
VISIT TO THE BOTANIC GARDENS.
The party assembled in the class-room where Professor
Balfour exhibited and described drawings of many inter-
esting medicinal and economical plants. On the tables
were placed living specimens of the British ferns, including
the rarer Scottish species. There were also on the tables
some most interesting alpine plants of Scotland. The
Botanical Museum was examined, the general arrangement
of the gardens, and various indoor collections were visited.
The scammony plant was seen covered with flowers in the
open ground, also the jalap plant with numseetreoonguesatnhfldeorwfeielnrt
buds. The weather was propitious and the great natural
and scientific attractions of the
mgaermdebnss
dined were
in great perfection.
At six p.m. a large party of members
the Hopetoun Rooms. Professor Chistison presided, the
ores' excitement
'dent's health being too feeble for the
necessarilywonnected with such a duty.