The evidence as to the increased powers of medicine to give relief from suffering and to prolong life is most clear and direct in the records of modern surgery--particularly in some of its special branches. In a large proportion of certain cases in which the surgeon now operates with a fair chance of success, such as calculus in the kidney or gall-bladder, shot-wounds of the abdomen, and tumours of various kinds, there was no hope in the year 1800, and the unhappy sufferer could only expect a certain, though often a lingering and painful, death. In cases of cancer of the face, tongue, breast, or uterus, the persistent pain, extreme disfigurement, and offensive odors which attended them made death a boon to be prayed for, if not deliberately sought, while now such cases, if brought in time to the surgeon, can often be entirely relieved. The knowledge of this fact has become general with the public, and patients no longer defer an operation as long as possible, as was their custom in days of old. Instead of having to look forward to the torture of incisions, manipulations, and stitching, with but small hope of surviving the exhausting suppuration and blood-poisoning which were such common results, the patient now knows that he will inhale a little sweet vapour, and sleep unconscious of the strokes of the surgeon's knife or the pricks of his needle. He may dream wondrous dreams, but he will soon awake to find himself in his bed staring at the trained nurse standing by his side, and wondering vaguely why the operation has not begun. He does not have to look forward to weeks and even months of daily dressings. The surgeon will glance at his temperature record and at the outside of his bandages, but will probably not touch them for a week; and when he does remove them nothing will be seen but a narrow red line without a trace of suppuration. These improved methods not only preserve the mother for her children, and the bread-winner for the family, but they greatly contribute to the public good by shortening the period of enforced idleness and unproductivity after operations.
Some of the greatest triumphs of modern surgery are obtained in cases of disease or injury of the abdominal organs. The removal of ovarian and uterine tumours is now so common and successful that it is not easy to realize that a hundred years ago there was practically no help or hope for such cases. In former days, the lists of deaths contained many cases reported as inflammation or obstruction of the bowels, or as peritonitis. It is now well understood that most of these cases are due to disease of a little worm-like appendix connected with the large intestine on the right side of the lower part of the abdomen, inflammation of which, known as appendicitis, causes excruciating pain, and often produces internal abscesses and death. An operation for the removal of such a diseased appendix is now common, and in most cases successful. The operation for the removal of calculus, or stone, from the urinary bladder dates from over twenty-five hundred years ago, and no one knows who first performed it. Within the last century it has been largely superseded by an operation which crushes the stone to powder within the bladder, and removes this powder without the use of the knife. The removal of calculi from the kidney or from the gall bladder, and the removal of a diseased kidney, are new operations, made possible by improved means of diagnosis, anæsthesia, and antisepsis [determining disease, causing insensibility, and excluding microbes]. Wounds of the intestines were formerly thought to be almost necessarily fatal, and nothing was done for them except to stupify the patient with opium. Now in such cases the abdomen is opened, the lacerations of the bowel are closed, the effused blood and other matters are removed, and in many cases life has thus been preserved.