ADVANCES IN SURGERY.

Press, Volume LXIX, Issue 20916, 25 July 1933, Page 17

ADVANCES IN SURGERY.

LATEST DISCOVERIES. ADDRESS BY DR. D, N. EPPSTEIN. Remarkable advances made in surgery, from the days of the potion and the incantation to the modern electric knife, and tfre use of avertin as an ancesthetic, were detailed by Dr. David N. Eppstein to a luncheon gathering of the Cnristchurch Business Men's Club at the Frascati yesterday. "The very early doctors did some amazing things," said the speaker. "They relied upon peculiar incantations and the administrauon of strange potions to effect cures. To-day surgery is an established science, having emerged completely from the dark period. Chloroform and ether were discovered 07 years ago and thus one grave limitation to surgery was removed, in spite of considerable opposition from the churches. However, anaesthesia was even mentioned in the Bible in one sense, for Adam was put to sleep while a rib was removed from Nm for the creation of his partner. Eve. Making the Patient Drunk. "In the early days surgeons had to make their patients very drunk and then work with the greatest speed. There were many grave difficulties to be overcome, and one of the worst was sepsis. The early-day surgeon, when about to perform an operation, donned an old coat, stained with past successes, had very little means of preserving antiseptic conditions, and sepsis was monotonously frequent." In 1860, Joseph Lister, a very humane man, set himself out to solve this problem. His' attention was drawn by' a friend to '.lie work of Pasteur, in Paris, and after much study he found that sepsis was due to micro-organ -ms. Instruments, the hands, and clothing were then sterilised with carbolic acid and a spray was used on the wound. The rate of mortality dropped greatly and at last surgery was able to advance more rapidly. However, it was some years before Lister's methods were wholly accepted in England, although Germany and America were quicker to take them up. To-day sepsis still occurred on occasions, but it was practically nonexistent after operations, and surgeons i could work without fear. In the last 50 years accurate diagnosis had progressed remarkably, and in 1895 Xrays were discovered by Professor Rontgen. Diseases of the bone then became discoverable. Since the war the barium meal had been used, forming opaque conditions in i tomach, and thus both it and the intestines could be examined by the rays. Now, an injection of opaque substance could be introduced into the blood stream, enabling a doctor to examine the kidneys. Moreover, the brain could also be investigated by means of Xrays. In the last year or so some Portuguese workers had been able to secure pictures of the blood-vessels of the brain, and these were of immense value. Internal Photography. In Paris, recently, a surgeon had invented a tiny camera which could be swallowed and thus internal pictures could be taken. It was as yet too early to say whether they would be of any practical use. The cause and process of disease were constantly being investigated in the laboratories. Cultures, grown artificially, were of great help to the scientists, and by means of a remarkable film, in which the "~tion was speeded up many thousands of times, the growth of cancers and the effect upon them of radium could be observed. Doctors of the old days had few armaments—a scalpel and the hands. Today they had radium and the electric knife, which prevented haemorrhage to a very great extent by sealing up the blood-vessels and destroying cancer cells. Actually it was not a knife in the accepted sense of the tenn, but was a fine needle point with which was employed an electric arc. Heavy Cost of Radium. Some idea of the enormous cost of radium was given by Dr. Eppstein. One gramme, he said, cost £20,000. It underwent a constant change, eventually turning into lead, but for one half of a gramme to turn into lead would take 1800 years, and the same period for the other half. Radium gave of! alpha, beta, and gamma rays, the latter destroying cancer cells. The needles were placed in the tissue of the patient and left there for about a week. Even after they were re moved the action continued for another three or four weeks. Referring again to anaesthetics Dr. Eppstein said that to-day a patient could be put to sleep in his bed and know nothing, even of going to the operating theatre. Often when he awoke, some hours later, he asked when the operation was to take place. A vote of thanks was accorded the speaker on the motion of Mr Peter Hockley Mr Alan J. Wills, president of the club, was in the chair. u rk un^ U1 uis bought the worst roots have been checked. When refilling the trench ram the soil firmly under the ball, and when rearranging the roots, alter the course , thick ones, which were shortened, placing them in a horizontal position, so as to prevent their going straight down again, probably into bad soil Cover the roots carefully in several layers, all placed horizontally and make each layer firm. It is im- ! portant to make the soil firm as rearranging the roots goes on, otherwise it will sink and carry the roots down with it It must be realised that while young trees may be root pruned almost with impunity, it is a very different matter in the case of old trees. If the roots have travelled far, and the young feeding roots at their extremities are, therefore, at a considerable distance from the stem, complete severance of all the large roots would so check the vitality of the tree that it might not recover for years, or it might even die. It is a safer plan, therefore, Ito do the operation in instalments, taking, say, one-half, or even onethird, of the root system in hand one season, and doing the remainder the following season or two following seai sons, as the case may be. I An old tree with low vitality can often be brought into a better state of health by taking the old soil away from the roots and replacing it with good, fresh loam with which some bone 1 meal has been incorporated. If some old lime rubble can be obtained, it is advisable to mix some in at the same time. Many old trees can be rejuvenated in this way, and, especially in the case of good varieties, it is generally advisable to do so when their vitality is not too much dissipated. In the cape of young trees—and by this is meant trees which have come to the fruiting stage—if growths of two or three feet are being made, and few flower buds are being produced, it is an almost certain indication that the roots are getting down into the subsoil, and that they require attention. Suckers are sometimes produced from the roots, and in most cases are very persistent. This is often the case with plum trees. The best way to get rid of them is to cut away entirely the root from which they spring. It is sometimes possible to pull the root clean out of the soil. It is useless to cut the suckers off at the ground level, as this only causes them to come up thicker than ever.