PASSING OF SURGERY

Waipa Post, Volume XXIV, Issue 1638, 7 May 1925, Page 2

PASSING OF SURGERY

“ From prehistoric times until rather less than half a century ago surgery was a desperate remedy for desperate diseases,” writes Dr C. W. Saleeby in the Outlook. “ Not even the blessed introduction of anaethesia in the 40’s had altered that fact, which depended not upon the immediate pain and fear and shock, but upon the extreme probability of subsequent inflammation and blood poisoning.

“Then came Pasteur, the French chemist, with his epoch-making discoveries in bacteriology, and Lister, the English surgeon, who applied them, in Glasgow, in a ward lately destroyed by vandalism, to the operation for compound fractures, with immediate and glorious success. Hence antiseptic and aseptic surgery; immunity for the patient, impunity for the surgeon; the brain and the abdomen, and even the heart, became amenable to the knife, which could be used for merely aesthetic purposes, for diagnosis, or for sheer fun.

To decry modern surgery, especially after the first European war in which it was really applied as it should be, would be folly. A dozen years ago I wrote a book in its honour, and a few lines from Lord Lister are among my most treasured possessions, but there is much more to say to-day by way of warning and prediction.

“ Our minds being what they are, most of us can grasp a new half-truth only by dropping that half which, perchance, we already possess. Thus progress, as Buffon said, is in spirals, instead of straight ahead ad astra. Modern surgery was and is so marvellous that it very naturally absorbed the attention of a large proportion of brilliant youngsters in the past generation. It appeals to the mechanical engineering aptitude which many men possess. It is rapid, dramatic, and gives quick returns. “ Yet, fully recognising the science involved in anaesthesia, in antiseptics and asepsis, and in anatomy, we must also recognise that by far the greater part of modern surgery is, if not unscientific, dependent for its province upon the deplorable failure of science, and I will cite instances to show that the spectacular success of surgery actually caused the medical profession to forget some vital truths of observation and practice which it already knew, and the re-discovery of which is the most hopeful and striking part of contemporary medical progress. “ All the recent statistics suggest that appendicitis, like cancer of the alimentary canal, is a disease of civilisation, dependent upon the absurd follies of our modern dietary and sedentary lives. Wihen we learn what these follies cost there will be an end to appendicitis and its surgery. Similar observations apply to the surgery of the gall-bladder and gall-stones. From a great surgeon who has been kindly treating my broken leg and knee during recent weeks I learn that the Rontgen rays are now banishing surgery from the treatment of enlarged prostate—and countless men must be grateful therefor hereafter.

“ There are two excellent reasons already why we may confidently predict the passage of the surgery of cancer. The first is the blessed advent of the Rontgen rays (and radium). A better reason for the passing of surgery in cancer ere long is to be found in our elucidation, one by one, of its causes—its many causes, not its ‘causes,’ as we say—and its consequent prevention.

“‘Chronic irritation,’ said Virchow, generations ago, and he was right. Today the cotton manufacturers, thanks to a recent legal decision, are thinking how to avoid the chronic irritation of a revolving spindle plus crude oil, and there will be so much less cancer amongst the operatives. This is only one of a host of instances. The dentist can suggest others, and the enemies of constipation, and so on. Am I too sanguine in assuming that, having gained such vital knowledge, we shall apply it? I hope not. “ The special hospitals for women are full of the victims of hastjf, dirty, or otherwise incompetent midwifery. An easily preventable venereal disease accounts for probably one half of all cases in which abdominal surgery is required in women. We can, and will, make our midwifery worthy of a civilised country—the country of Lister and Nightingale—and we are already stehdily conquering the venereal diseases. There should be very little need for operative gynaecology left in progressive civilised countries in another decade or two. ’

“ Space fails. I had meant to discuss ‘ tonsils and adenoids,’ and to ask how much surgery of the ear will be left when we properly care for measles and whooping cough. But the foregoing should suffice. And if the ardent youngster wants a specialism worthy of any man’s powers he will find in biochemistry that whichvis destined to some day recreate mankind and leave all fabled Edens nowhere,” concludes Dr Saleeby.