An Address on the Surgical Aids to Medicine
Authors: T. C. Allbutt
Journal: BMJ (1882)

GENTLEMEN,-As I rise to address you this evening, I know not which is the stronger feeling in me-the pleasure-the honest pleasure I may frankly avow in the distinction your invitation confers upon me, or the diffidence which tells me I am unworthy of the duty to which I am called.Your kindness gives me courage to believe that I shall at least have gentle judges.The subject of an address like the present should, I venture to say, be a practical one.It should come home to every man's experience, and concern itself with every man's craft.To deal more widely with things, to take views of them so lofty that the details of our daily work recede into the distance is more proper in essays written for the student.These can be tested by no ready touchstone, but will be judged by time and longer labour.For this reason I have chosen a subject to- night upon which each one of my hearers can be the instant critic, and which deals with the details of our common practice.By the title Surgical Aids to Medicine, given to my paper, I wish to signify the relationof help which the surgeon can give to the physician, and to speak of those maladies which, though belonging to the sphere of the physician need the hand of the surgeon for their adequate treatment.It has been too hastily said that specialism has been the bane of mo- dern medicine, and that the divergent paths of our closer researches have led us away from those comprehensive views of our art which alone can give us mastery as practitioners.If this assertion be made as a dae warning against quackery, or as a paradoxical way of impressing upon us that analysis alone without syn- thesis may be profitless, then, accepting it at its true value, we may take it at its worth.But I fear the charge against specialism means more than this-is no mere denunciation of selfishness, of pettiness, or of strenuous trifling, but is aimed against subdivision of labour as a mode of progress.I scarcely need combat such an opinion as this, nor seek to show you that, without the devotion of gifted men to narrow fields of investigation, the science which inspires our art cannot prosper.Whither they have preceded we must follow, and with them seek to em- body their new gains with the old.Not only must this be true of the remoter deviations of medical inquiry, but it is true also of the larger contingents of our art.That any one part of medicine can fail to de- pend upon, and to interosculate with the rest, is of course impossible; but on the other hand, in respect of our limited faculties, we must do provisionally and artificially what nature does not do-if we are to grasp firmly, we must limit our embrace.The old standard divisions of medicine into medicine, surgery, and midwifery, are then designed not in the following of nature, but for the sake of our own infirmities.Even when medical science was more restricted than it is to-day, no man could attain a fine and progressive mastery over more than one of these gpeat divisions, and with the increase of time such a range of power becomes less and less attainable.By taking parts from each, distinction may be reached partly upon surgical partly upon medical lines, and such integrating kinds of work are invaluable to us; but so far as I know, no one man was ever both a great surgeon and a great physician.Not only is the field too large, but the mental habit seems different; and we are thus compelled to recognise our limitations, and, labouring each in our own sphere, take good heed of the dangers of isolation, and avoid them as well as we * An Address delivered at the Inaugural Meeting of the Midland Medical Society, October l9th, i88i.may.Perhaps the majority of my hearers are not devoted exclusively to medicine, surgery, or midwifery, respectively, but are engaged in the attractive field of general practice.There is something very fascinating in the freedom of that practice which, rapidly gleaning the chief results of the more special workers, binds them into temporary unity, and, seeking rapid and effective combinations for instant needs, develops a class of men inferior to none, if not superior to any in dexterity and versatility, in variety of knowledge and readiness of resource.Yet, even in the ranks of general practice, the distinction between physic and surgery is not lost; and not only in later life, but even in the wards of our hospitals, our better students betray some personal leaning and fitness for the one branch of their profession or the other.Thus it is, perhaps, that the border subjects lying between surgery and medicine