Wounds of the Heart, Remarks on, With Notes of a Case in Which Death Took Place Four Months and a Half Subsequently, and Cica- Wounds, Traumatic or Surgical, Some Obser- ages or Dressings 118 25 210 First Vice-President.. .W. B. ROGERS, Memphis, Tenn. Second Vice President.... ARTHUR D. BEVAN, Chicago, Ill. Third Vice-President.. ..GEO. F. BEASLY, Lafayette, Ind. Fourth Vice-President.... H. LOGAN, The Dalles, Ore. Fifth Vice-President......GEO. GRAVES, Herkimer, N. Y. Sixth Vice-President.... .P. F. VASTERLING, St. Louis, Mo. Seventh Vice-President... A. C. Scott, Temple, Tex. D. EMMETT WELSH,Gr'd Rpds, Mich. Assistant Secretary. .......S. R. WOOSTER, Grand Rapids, Mich. Treasurer..... ........E. R. LEWIS, Kansas City, Mo. Executive Committee:-A. J. MULLEN, JR., Michigan City, Ind.; C. D. EVANS, Columbus, Neb.; F. H. PECK, Clinton, N. Y.; A. A. THOMPSON, Waxahachie, Tex.; S. S. THORN, Toledo, Gentlemen of the National Association of Rail- Impressed with the honor which has been delegated me to welcome you here to-day, permit me, in the name of the grand old city of St. Louis, in the name of the municipality, in the name of its citizens, in the name of its physicians, and, as health commissioner, to ex- tend to you a most hearty and cordial wel- come. In the active field of our profession, the study of railway surgery has made strides in directions of scientific investigation so ex- tensive, that to-day railway surgery is in itself one of the progressive sciences, a specialty which requires a knowledge equal to that of any specialty in our profession. The homes of our city are open to the National Associa- tion of Railway Surgeons. St. Louis is noted for its hospitality; the physicians of St. Louis for their progress, congeniality and good-fel- lowship. Our ladies are the sweetest and pret- tiest on the continent, and the only fear that I entertain in welcoming you to our homes, is that the unmarried men take from us too many of the bright, blushing roses of our Recently, in looking over the surgical litera- ture of the early part of the present century, I was forcibly struck by the following senti- ment expressed within a present lifetime, April, 1850, by one of the most able and dis- tinguished professors of the oldest medical given it by the combined influence of the medical profession, that there is no cure for any disease, no single remedy, no happy combination of remedies for any disease which has ever affected humanity." That is to say,that medicine and surgery in all the years from Esculapius to that time had not advanced to the dignity of a science, but remained a simple art, based upon the empirical observation of what was good or bad for men. What can 1896 answer back to this grave utterance? What has the last half of the present century done for surgery? Let us review, briefly, the history of these few years, so full for the welfare of mankind. Dr. R. B. Carter, in a paper on medicine and surgery, in "The Reign of Queen Victoria," says: "The anaesthetic age has changed the whole aspect of surgery. Prior to 1847, surgical operations were few in number and almost limited to the amputation of limbs, the removal of cancerous growths and other tumors, the resection of a few of the larger joints, cutting for stone, and the ligature of main arteries for aneurism. The pain suffered by patients was so great as to tax severely the endurance of the bravest and strongest and to depress seriously and beyond recall the powers of life. Death from shock was by no means uncommon, the patient sinking in a few hours from the actual suffering that he had undergone. It was a point of honor with surgeons in those days to abbreviate such agonies as much as possible and to cultivate mere speed in operating, as the highest and most valuable form of dexterity. Nothing was attempted which could not be done quickly, and an amputation, in the hands of a skilled surgeon, had almost the appearance of a feat of legerdermain. For the separation of a lower limb above the knee (of course not including dressing), twenty seconds have been known to suffice, while forty seconds was regarded as a period of time which no man was justified in exceeding." In 1847 the anesthetic age commenced. How sternly does this discovery teach that man must earn every boon from nature by his own incessant striving! And how strange that the simple chemical and physiological secret of ether should have hidden so long in its easy formula, undiscovered through all these waiting centuries, when pain was the omnipresent tyrant, which science could not control. Ether and chloroform had the key, but not until many years afterward did the hand of a citizen of the United States, an American dentist, Dr. Jackson, fit it into the golden doorway behind which sat waiting an angel of pity, kinder, more beneficent and more powerful than an Arabian fairy ever suddenly revealed in her divine beauty and bountifulness, to any prince or magician of the thousand and one tales. To surgery, anæsthesia gave a sure control of anguish. To the surgeon, confidence, quiet, leisure. It came like a revelation to surgeons, that they need no longer be in such a frantic hurry. To those who have to be under the knife, it gives a sweet and complete oblivion; a world of "black velvet" tranquillity, of which these magic drugs keep unbounded store; and to awake grateful beyond words for the soft spell of peace. Anæsthesia gave a sure control of pain and robbed the operating room of its terrors, but afforded no help in the healing of wounds. In 1858 the great French scientist, Louis Pasteur (to whom surgery owes a lasting debt of gratitude), began his memorable battle against the fallacious doctrine of spontaneous generation, and by its overthrow in 1860 he laid securely the foundation of the modern. science of bacteriology. In 1865 a young surgeon in one of the Edinburgh hospitals was the first to see the vast merits of Pasteur's bacteriological labors. ological labors. His practical mind, instinct with genius, seized upon and closed with the conception that the healing of wounds was prevented by the entrance of micro-organisms into them. Touched by this wand, difficulties fell before him. He began his great battle for antiseptic surgery that has in so short a time. changed the whole aspect of surgery and led to such marvelous and beneficial results. This young man is now the venerable Sir Joseph Lister, whose splendid achievements have lighted up the dark places of surgery and transformed the treatment of wounds from a matter of uncertainty, and too often disastrous empiricism, into a scientific art of sure beneficence. Thanks to him, surgery has undergone a complete revolution which has deprived it of its terrors and extended almost without limit its efficacious powers. To no class of surgeons do the benefits of these discoveries appeal with greater force than to railway surgeons. Surgery, being the most practical of the medical sciences, necessarily attracts to it the cream of the medical profession, the greatest intellects, the greatest manipulative skill. In welcoming you to this city, gentlemen, I know that I am addressing the cream of the medical profession of this country. AN ADDRESS* BY HON. ALEX. G. COCHRAN, GENERAL SOLICITOR, MISSOURI PACIFIC RAILWAY, ST. LOUIS, Mo. Mr. Chairman, ladies and gentlemen, and members of the National Convention of Railway Surgeons: It affords me a great deal of pleasure to be with you to-night, and I very highly appreciate the honor conferred upon me by the invitation of your committee to address this distinguished assembly. The newspapers stated that I was to deliver an address. I do not like the word "address," for somehow or other I always find that when I have anything to say I can always say it so much better if I can take men by the hand, look into their eyes and talk to them in the ordinary, everyday manner. That is the way I would like to feel toward you tonight. I know that all real good lawyers are good fellows, and I have no doubt that you will agree with me in saying that all good surgeons are good fellows, too. I have come here to-night in a quiet, unostentatious manner and shall not attempt any oratory, but just simply look at you and give you an informal talk. It is a pleasure to me to look into your intelligent faces, and I want to speak to you just as if we were sitting down and having a conversation. You are railroad surgeons, I am a railroad lawyer. I have always felt that the professions of the law and of medicine were nearly akin. They are both splendid professions, requiring the strongest intellects and the greatest and closest application and labor. They are both professions with the highest possible standards, and there is no time, however long we may be spared to live upon this earth, when any man, who is a member of either profession, will be prepared to say that he knows all about it. On the contrary, it seems *Delivered at the Ninth Annual Meeting of the National Association of Railway Surgeons at St. Louis, April 30, 1896. to me that the older we get, and the more knowledge that we acquire, the less we feel that we know about the great subjects to which we have devoted our lives. In this connection I desire to briefly relate a little incident which occurred some years ago. A young man, who had just graduated from the Harvard Law School, and lived in New York, was on his way home, and, of course, felt that he was a big man. He had his sheepskin in his pocket. His professors had shaken his hand and bade him God speed in going out into the commercial world. As he got on a boat at Fall River, he noticed on deck an old judge, a man who had known him from boyhood and was a great friend of his father. The young man went up to the judge, took him by the hand, and said: "Judge, I am all through studying law." "Well, now," the judge replied, "permit me to congratulate you. I have been studying law for upward of fifty years, and I feel that I have only just commenced." When I remember the marvelous advances that have been made in surgery and medicine, even in the short span of my own life, I am almost appalled. When I was a boy the standard prescriptions for most ills for grown people and children were Dover's powders, castor oil and turpentine. (Laughter). I went through that treatment two or three times myself. Look at the progress medicine has made since that time! It has not come by accident. Far from it. It has come by your patient labor day and night, through months and years of the toiling men of your profession, who have bestowed the untold blessings upon humanity which they enjoy to-day. And yet with all your knowledge you have just simply picked a little of the surface, for beneath lies the great mine of wealth which is yet to be uncovered and shown to the world. This is true of law also, but eminently true of medicine and surgery. Take the new medicines that have been discovered. Think of all those wonderful medicines we have now, the products of coal tar. Think of cocaine. Look at the various other medicines which I cannot enumerate here, but which are familiar to you and have become known to you only in the last few years. Take surgery. Many of you remember the time-I remember it well-that when a man was known to have a wound of the intestines, the wisest and most skillful sur |