of which now runs the silver thread of knowledge instead of ignorance.

With this the brilliant results of the antiseptic system have joined to give us a new surgery. Sir Joseph Lister, to whom we chiefly owe this knowledge, has done more to save human life and diminish human suffering than any other man of the last fifty years. Had he only made practicable the use of animal ligatures, it would have been an untold boon, the value of which can only be appreciated by doctors; but he has done far more, he has founded a new system of surgery. We may reject the spray and carbolic acid, but the surgical world, regardless of details, with few exceptions follows the principles upon which his method is founded and humanity is the gainer, by the nearly total abolition of inflammation, suppuration, secondary hæmorrhage, blood-poisoning, gangrene, and erysipelas, as sequels of accidents and operations; by the relief from suffering and death, by operations formerly impossible; by rendering amputations and compound fractures safe and simple instead of deadly. Reflect on what each one of these brief, but momentous, statements means!

But we have by no means reached perfection. Lister himself, no tyro, but the great master, is still searching for further improvements. But when lately he desired to make some experiments on animals, still further to perfect our practice, so many obstructions were thrown in his way in England that he was driven to Toulouse to pursue his humane researches.

I had intended also to speak of many other practical benefits to man directly, but can only mention such important matters as the surgery of the thyroid gland, the seat of goitre; the surgery of the lungs, part of which have been removed; the surgery of the nerves, removal of the entire larynx, the remarkable researches of late years as to the periosteum in the reproduction of new bone after removal of dead or diseased

bone; Bernard's important observations as to diabetes; Brown-Séquard's experiments on epilepsy, the modern extraordinary advance in nearly all the diseases of the nervous system, and a number of other discoveries, as to all of which experiments upon animals have added largely to our knowledge, and therefore to our means of diminishing suffering and saving human life. For many of these, as well as for the most judicial discussion of the vivisection question I have yet seen, I must refer you to that remarkable book, "Physiological Cruelty," written, not by a man, but by a woman.*

I had also intended to refer in detail to the splendid results of vivisection in relieving the sufferings of animals, and in preventing enormous pecuniary loss to man. We are only beginning to see that vivisection is as humane to animal life and suffering as it is to human, and that for financial reasons as well as humane motives it is of the utmost importance to the State that such diseases as cattle plague, splenic fever, chicken cholera, swine plague, and others, should be eradicated. Vivisection has shown us how this may be done, and has so conferred upon animals, too, the boon of life and health. For all this, however, I must refer you to the recent admirable lecture by Prof. Robert Meade Smith, of the University of Pennsylvania.†

One subject, however, is so recent and of such interest, both to man and animals, that I must not pass it over-I mean that justly dreaded disease hydrophobia. Thanks to vivisection, its abolition in the near future seems no longer to be a matter of doubt.

Within the last three years Pasteur has announced that, by passing the virus through the monkey, he has been able to protect dogs from hydrophobia by vaccination with this weakened virus. The French government recently appointed

* See also the just issued Life and Labors of Pasteur.

†Therapeutic Gazette, Nov., 1884.

an eminent scientific commission to report on the alleged discovery.* Pasteur furnished them with 23 vaccinated dogs. These 23, and 19 others unprotected, were all inoculated from rabid animals. Of the 19 unprotected, 14 died. Of the 23 protected dogs, 1 died of diarrhoea, and all the others escaped. It has yet to be tried on a man suffering from hydrophobia, but, should our reasonable hopes be realized, what a boon it will be!†

With this brief summary of a few of the recent practical benefits from vivisection, I must close. I have given you only ascertained facts for your future use in the communities in which you may settle. They may assist you in forming public sentiment on a basis of fact, of reason, and of common sense. The sentiment of our own profession, so constantly and so conspicuously humane, are always against inflicting pain; but if in yielding to sentiment we actually increase disease, and pain, and death, both among animals and men, our aversion to present pain is both unwise and actually cruel.

* Medical News, August 30, 1884.

In the last twenty years "Pasteur Institutes" for the treatment of hydrophobia and some similar diseases have been established in nearly every civilized country in the world. Of persons bitten by animals believed to be rabid, heretofore about sixteen per cent. developed hydrophobia, and every one died. In the thousands of such cases treated by Pasteur's method even those bitten by animals known to be rabid the mortality is less than one per cent.-(W. W. K., 1905.)

RECENT PROGRESS IN SURGERY.*

IN

N no department of medicine has there been more rapid and in many respects more astonishing progress in recent years than in surgery. This progress is due chiefly to two things-the introduction of antiseptic methods, and to what we have learned from laboratory work and experiments upon animals.

It has long been known that a "simple" fracture, in which the skin is unbroken, and a "compound" fracture, in which the skin is broken and the air has easy access to the fractured bone, were vastly different in their dangers; but why the communication with the air was so dangerous was a mystery. Of late years, however, the germs existing in the atmosphere, and on every material coming into contact with the wound, such as dirty clothing, ordinarily clean instruments, the skin of the patient, the hands of the surgeon, and the dressings, have been investigated by a large number of observers, and it has been abundantly proved that infection comes not from the wound itself, but from the exterior, and that this infection from without is the cause of inflammation and of its speedy sequel, the formation of "pus" (that is,"matter"). Once that the pus begins to form, fever, abscesses, bloodpoisoning, gangrene, erysipelas, one or all, may start up into ominous and fatal activity. Inflammation and suppuration (that is, the formation of pus), then, are the causes of all these evil processes. They are all called briefly "septic" (that is,

*Reprinted from Harper's Magazine, October, 1889, by the kind consent of Messrs. Harper & Brothers.

"poisonous") processes. Hence "antiseptic" methods are those that prevent inflammation and suppuration.

Now we see why a compound fracture, or any other "open" wound (that is, one in which the protective defense of the skin is destroyed), is so much more dangerous than a simple fracture, or a subcutaneous wound. It arises from the fact that these septic germs, or "microbes," have easy access to the tissues, and, once there, multiply with almost incredible rapidity, and quickly set up inflammation and suppuration and their consequences. At first it was thought that the chief danger lay in atmospheric germs, but later investigations have proved that the skin of the patient, and especially the hands of the surgeon, and his instruments and sponges, and even his dressings, are far more frequent sources of infection.

Perhaps I cannot better illustrate the difference between the old, or "septic," and the new, or "antiseptic," surgery than by describing two amputations, one such as was commonly done, for instance, during the Civil War, and the other such as is done now by every good surgeon. In fact, it is only within the last ten or fifteen years that antiseptic surgery has become generalized in the profession.

Let us suppose an amputation above the elbow, and the operator the best surgeon of the Civil War. The arm was not specially prepared, except that it would be cleaned of its coarse dirt arising from the accident, but that would be all. The instruments were taken out of an ordinary case and placed on a table, and during the operation were frequently placed upon the patient's clothing, soiled often by the accident necessitating the operation, as well as by more or less wearing. If the instruments or sponges fell upon the floor, they would be picked up, dipped into water, and then used with innocent equanimity. The sponges, washed and dried from the last operation, were simply thrown into a basin of ordinary water. The hands of the surgeon were as clean as a gentleman would