On the surgery of the knee-joint : and the responsibility placed on the physician and general practitioner by the modern progress of surgery : being the inaugural and retiring presidential addresses delivered before the West London Medico-Chirurgical Society, on October 7th, 1887, and May 4th, 1888, respectively / by C.B. Keetley.

Keetley, Charles Bell, 1848-1909.

Date:: [1888]

Credit: On the surgery of the knee-joint : and the responsibility placed on the physician and general practitioner by the modern progress of surgery : being the inaugural and retiring presidential addresses delivered before the West London Medico-Chirurgical Society, on October 7th, 1887, and May 4th, 1888, respectively / by C.B. Keetley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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spread widely throughout the whole profession a good working knowledge of the earliest symptoms of such affections as intestinal obstruction, perforation of the appendix vermiformis, or of other parts of the diges- tive tract, rupture of the stomach, or of the bladder, or of the kidney, renal calculus, peritonitis, perity- phlitis, the various affections of the female generative organs, amenable to surgical treatment, and, passing to another part of the person, intra-cranial abscess and haemorrhage and tumour. This anything but exhaustive list is given by way of example. Now, how many men are there in this room, how many are there in this city, how many in Great Britain, who have as good a practical knowledge of the diagnosis of, say, not only intra-cranial abscess, but even of renal calculus and acute intussusception as they have of typhoid fever and of pneumonia ? Let our own consciences reply. And yet these things which are so obscure to many of us are not so exceedingly rare ; they are also terribly fatal, but wonderfully remediable by correct surgery promptly applied, while such diseases as pneumonia and typhoid often require no active treatment whatever. At all events, in dealing with the latter, a policy of waiting until the diagnosis is clear may do no harm. But in the case of almost all the acute, and some of the subacute, internal diseases now brought into the province of surgery, to wait is to be lost. I would like to go into detail and tell of case after case in which the surgeon was appealed to by the practitioner, or even by the consulting physician, only when the shadow of approaching death had already crept over

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