The times. [volume] (Washington [D.C.]) 1897-1901, 1901-02-03

''skillfur skiagrapher. for it must be re-
membered that there may be the same DIFF
ference in the personal skill and, there
fore, I'm the reliability of the results in
skiagraphy rs there is in photography. A
poor photographer will get very different
results from skillful one. even If he uses
precisely the same quality of plates and
precisely the same camera. Personal skill
and experience In the s<iagrapher is,
therefore, one of the most important ele-
ments in success. 1t must be remembered
also that the X-rays in not a few cases
may mislead us. l have. personally, frac-
tured a bone on account of deformity.
taken an X-ray picture Immediately after
the operation the picture showing not the
slightest evidence of n fracture which l
absolutely knew existed Moreover. for
eign bodies found on the outside of the
person may mislead us. as. for example.
the metal part of suspenders coin in
ones pocket. and such like. They look in
the picture as if they were inside rather
than outside the body. and any article
the shape or size of which would not re-
veal its nature might easily be mistaken
for Il foreign body within the patient
Therefore, in many cases only an expert
can determine precisely what the ska
graph means. / especially mention this.
because there is tendency at present to
utilize skiagraphs in court IN order 70 con-
vince the jury that suck a picture is an
evidence of malpractice. Such pictures
always need an interpreter in order to
judge correctly of their meaning 1t is
precisely as II the jury were asked to look
rr,i..
accustomed to use the microscope for
thirty years but there are many instances
even yet in which | am obliged to ask a
patholoeist or bacteriologist what I really
am looking at in the microscope While
one may make a mistake of small moment
In some cases, yet if mans life or liberty
or purse is at the mercy of a jury which
does not know how to interpret a ska
graph and may, therefore give verdict
which is precisely wrong" as Prof. Lin
coin. my old teacher of Latin. used to call
many of our transit tons, it will be a very
serious matter and lead TO gross injustice
XvI.-CITY AND VILLAGE HOSPITALS.
Another great improvement in our
means of caring for our surgical patients
is the establishment of hospitals all over
the land. These. happily, are not limited
to our great cities, but in every country
town and not a few large villages, small
but well-equipped and well-managed hos
pitfalls, have been established. which. have
done incalculable good. 1t is not too much
to say that every city or town establishing
such hospital is repaid hundredfold.
XVIL-TRAINED NURSES.
The trained nurse has fortunately come
to stay. In fact. our antiseptic methods
as above described have made the trained
nurse Indispensable. The old nurse who
by many clumsy experiments on her pa
tents had obtained a certain rule-of-
thumb knowledge of the care of the sick
can no longer assist in surgical operation
or properly care for any surgical patient
The modern nurse must of necessity be a
well educated, well trained woman, know
ing thoroughly modern antiseptic meth
DDS and on the alert to observe every
symptom of improvement and every signal
OF danger.
Without a well-trained nurse it is inn
possible at the present day properly to
care for any serious surgical case, and /
gladly bear witness to the intelligence,
fidelity. and skill of scores of nurses who
have assisted me and without whom
should have felt as one blade of scissors
without its fellow.
XVIII.-SPECIAL OPERATIONS.
(a) AAIPUTATIONS AND COMPOUND
RACTURES.-Having now traced the
different modes of thought which have
aided surgical progress in the present CEN
fury and the different means of investiga-
ton, let us turn finally TO the progress of
individual operations. AS to amputations
and compound fractures. have already in
dicated the immense improvements which
have followed the introductions Of anaes-
thesia and especially Of antisepsis which
have brought the mortality of amputa-
tons down from 50 per cent or 60 per cent
to 10 per cent or Is per cent, and in com
pound fractures, once SO dreaded. since
the mortality was not infrequently as high
as two out of three to a relatively insig-
nificant danger
%, TUMORS.-In no department perhaps |
has the introduction of antisepsis and the |
antiseptic method brought about a greater |
improvement than in operations for tu- |
nnors. The startling reluctance OF Sir Asst |
ley Cooper to operate on King George " |
for so simple and small tumor as wen, |
lest erysipelas might follow, and even de-
forr,fa, ~.