An address on the surgery of to-day as compared with that of twenty-five years ago : illustrated by the work in the General Infirmary at Leeds : delivered before the Leeds and West Riding Medico-Chirurgical Society on Oct. 18, 1895 / by A.W. Mayo Robson.

  • Robson, A. W. Mayo (Arthur William Mayo), Sir, 1853-1933.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: An address on the surgery of to-day as compared with that of twenty-five years ago : illustrated by the work in the General Infirmary at Leeds : delivered before the Leeds and West Riding Medico-Chirurgical Society on Oct. 18, 1895 / by A.W. Mayo Robson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Thus there is not only effected a great saving of life and a much more rapid restoration of function, but a marked diminution in the time spent in hospital. In this way, as well as in the treatment of joint diseases, surgery has become much more conservative, and amputation is now only looked on as a pis aller, and almost as a sign of failure; though, if amputation has to be done, the mortality of to-day compares very favourably with that of twenty-five years ago, for, including all the major amputations, the mor- tality of 1870 was 20*8 and of 1875 25-60, whereas in 1894 it was only 11 per cent. This conservative tendency is exemplified by the care exercised to attain perfection in the repair of injured tissues, whether accidental or operative ; for instance, it used to be considered satisfactory to bring all the tissues in an abdominal wound together by sutures piercing the whole thickness of the abdominal wall, the result not infrequently being a yielding of the cicatrix and the development of a ventral hernia; but by bringing peri- toneum to peritoneum, muscle to muscle, aponeurosis to aponeurosis, and skin to skin, the integrity of the parts is restored and permanent weakness avoided. In no class of wounds does this great care show to more advantage than in injuries of the forearm and hands, where suture of tendons and nerves is thought of as much importance as union of skin ; even if there be a deficiency of nerve or tendon, modern surgery is equal to the occasion, since grafting of both can be successfully effected. The aiming at cure, or as nearly as possible at complete restitution, rather than simply at relief, is exemplified in the performance of ovariotomy in place of paracentesis, of excision of joints in place of amputation, of erasion or simply removal of disease instead of excision, of enucleation of thyroid tumours instead of thyroidectomy, and of prostatectomy in place of drainage or frequent catheterism. The operation for