The times. [volume] (Richmond, Va.) 1890-1903, 1896-11-08
CENTURY OF SURGERY
THE TWO GREAT BOONs or IN
TESIH ESfI md TfSEPTTCS
Place in Hospital Methods in the
Last Hundred Years.

beds. tho dainty liren. the open. sunny
roons filled with pure air, the attractive
| nurses IN their caps and aprons, ana inc
! tables laid with the implements for caring
| for the surgical cases, as II for AN entci-
| tainmtnt has hut small conception OF
| the CCudItiOu OF the wards of g. great met
! ropoltan hospital I'm Europe IN the lattef
| part OF the eighteenth century. lhttt arc
| few accounts which present an adequate
| conception OF the mode Of coniuctins
| hospital service in those lays. Some,
/ however. are eNtant. TO give some i0ea Oh
! the condition of such a hospital
| There Is one. tor instance, OF the no
| tel Dieu in Paris. Reports show most
! clearly 10 what depths of misery the pco-
! pie must have fallen TO accept the smell
ter of this pcstilcut hospital. I'm II were
| $500 beds, Tut during the winter season as
many as 300 patients were I'm tho puliu-
! ing at one time. This involved the piac-
| ing Of several patients in each bed, ana
they We're frequently arranged IN uers'
! one above the other. 50 that some were
! reached only by l. cans Of LADDER. mere
/ were no means of heating the Waius OF
/ the hospital. and such heat as thete VA.
| came from the closely PACKED poulea OK
1 the uatieuts The mortality as may be
| sfipposod was excessive There was one
! death out OF every four lStients thit en-,
| tered the hospital, and. as that lncluueu
| those that were little ailing, the IN
| sane and the maternity cases, some l"'h
|
| condition of the wards. Statistics or lhat
| perlod are unfortunately wanting, but IL
J has generally been supposed that, as
| rule those who submitted to an ampuld-
| ton of limb died Of blood POISONING
| Naturally. under these CIRCUMSTANCES
| surgical operations were few ana iar ne
tween Nobody was willing 10 submit 10
| such am ordeal unless absolutely compei-
| led TO do so By the necessities OF the case
| During war time when these hospllila
! We're crowded even beyond the UNITS
| which have been described. hospitdl us
eases. as they are called, were Iilshlilully
| prevalent. These included sucn altccllohs
| as hospital gangrenc, crysipelas, anu
| blood poisoning. During the wars OF w"
| French Revolution and IN the NapoleoHlc
/ wars surgical experience IN ihcsc dlscdsr9
| was enormous Extensive cpidemlcs
! claimed thousands of victims. Nor were
| they confined entirely 90 hospitals LOT
| history says that in the latter part OF
| tho last century and the beginning OF TINS
! France and Great Britain were swept nv
! epidemics OF crysipeld-, anu au"u' '".
| middle of this century a most widespread
! and virulonf form OF that disease appear
! al fn this country. carrying OFT thouShhu5
! of victims in the New ENGLAND states. IL
| also prevailed in New York ana len"sSi-
| Vauia. spreading from village 10 Nlidbe.
! u not only required great deal OF coui-
! age and resolution on the part Oh IL i3
/ tiont 10 enter one Of the great hospitals
of France and England during the open
| ing decades Of the present century, hue
! the ttulhie Cidfll Of the ope'NllJn lla'It
| was alorc sufficient 10 make the stouie71
| heart quail, and the dread ot what WIS
! 20 follow made the more Intelligent naiI-
| rally shrink from the risk when they
| V ere about o. run. The MASSACHUSETTS,
! Ccntral and the Pennsylvania hospllala
were the only Two large hospitals IN inns
country iu 1870. ln civil life surgery was
I . 4 d. iT
| IL was only after much persuasion ana
intelligent reasoning that the SUFFERER
| could Dee laced in such state OF NINA as
| TO Doe anxious for relief by the kniie.
During the first decades. of TINS century
| improvements in surgery consisted prlh-
| cinallv i'm the DEVELOPMENT of "a skiNiul
| technique in tho handling OF surgical IN
| struments. and in the deXterity ana "a
| nidity with which the operation should ue
| performed. The great masters oil sur
gerry acquired wonderful SKIN nm lntse
PRINCIPLES and were enabled TO TINS extent
10 mitigate the sufferings Of those VINO
were obliged 10 undergo surgical opera
tions. The art OF surgery had reached
about this stage az the tlNe Wheh inc
! use of ether WAS first introduced TO re-
lieve pain durins surgical operations.
| Previous 10 the operation at the Mt7si-
cLusetts General Hospital on OCTOBER 49,
1886. surgery bad been. as the eid n blsc-
low said. eat all times agony. ne mo-
ment that IL had been clEirly establish
| ed that au agent had been discovered
which could relieve pain iu surgery the
DAYS of anxiety which visited patients
and their medical advisers previous 10 an
operation were Immediately swept away
ana the problem of the RELIEF by surgery
became vastly simplned.
Holmes said OF this sublime clfcoNci3
"The knife is scsichins COR dlse.iee. tne
pulleys aic dragging btis dirlocattd
| limbs-uature hei-lll is working out the
primal CuisC. wlicl doomed ihe tenaei-
est OF her Cieatrlts 10 thc shNpcst az
her trials; lat the fierce extremity ol
suffering has lcen stepped ~ the waters
OF forgetfulr css and the deepest futro"
i'm the krctted brow of agony has been
smo0thcd away forever.
Tho result Of this great advance was
that surgical ope, atoms increased I'm num-
bcrs. There was an activity iu the oper-
aung theatre ln tin IS or peace mat hdd
never before teen known. Numerous OPP
DiatlOns were now performed, Whllh had
never been attempted.
But with this great increase IN surgical
activity came "a corresponding increase in
the diseases which have been from 'ime
immemoral regarded as hospital pests
and tho inevitable compartments az
surgical practice. IL Is true hat this time
many operations could be performed ih
the country IN private practise with re-
suits equal 10 those which are seen To-
day. The country doctor could tell OF tfl-
umphs in the healing OF the "oun Is on
his patients which the hospital surgeon
rarely had am opportunity 10 observe.
Among the scientific men who were at
tempting % solve the problem OF bringing
about ideal results that were obtained
only lon exceptional cases was Sir James
Simpson, Oi Edinburgh. with his thought
ful and suggestive papers on hospitallsn
and whose name afterward became so IA
nous in connection with chlOrOlOrm. on
the breaking out OF the civil war the art
OF hospital construction received new
impetus. 10 WAS thought thar, 10y I'M
proving the atmospheric conditions. nos
pital epidemicg could be more eUrCiuaiiy
controlled old buildings, which had serN-
al for years We're torn down, and now
ANA cOmmodiOus pavillons TOOK thtlf
places. During the civil war. however,
Notwithstanding the perfection 10 which
this system was carried. epldemes ragged
with an the freedom which they mad ig
the camnaieus of France and Russia and
I'm the naval ccmhats OF the last century.
The writer can well remember al this pc
Rod the epidemic of hospital ganerene IN
the Massachusetts General Hospital, IT.
self "a hospital which even az that time
had world wide reputation Tor neatness
and efficiency and a proper regard Tor
the principles Of hygiene SO Formidable
were it's ravagcs that all surgical opera
tions were for some time abandoned. The
only method that existed az that time
for controlling such eruptons OF diseases
was the system Of isolation. as carried
ont I'm separate or pavilion wards, or by
the removal of patients 10 tents IN the
open air.
Anaesthesia had already been in exist
ence for twenty years when the urst
scientific attempts 10 control tne nice
tlous diseases of surgery were made. A.
hoe ofr,.dr hg.n stated IL was known