Page:The Evolution of Surgery.djvu/19

 abdomen all these things have become common-places of our knowledge.

We smile to-day at Aristotle's view that the brain was an organ destined to cool the heart and that the latter was the organ of the mind, and we find it hard to believe that there could be rational therapeutics before Harvey discovered the circulation of the blood, but surely our knowledge of many diseases with which surgery now deals daily is almost as much a revelation to the present generation as were the fundamental facts of physiology to a former day. The acquisition of this knowledge of diseased processes during life and during their early stages, and the precision of observation obtained in recent years have I think altered our whole mental attitude and given us a clear conception of the objects of surgery which marks a further stage in its evolution. What the skiagram has taught us about the bones the human eye has taught us about the rest of the body, and we no longer think and speak of pathological conditions as our fathers imagined them to be but as we ourselves have seen them.

And again we are led by a most natural transition to another factor in the evolution of surgery. The extension of operative treatment has demanded and obtained an accuracy of diagnosis which was formerly not required and not obtained. The operating surgeon has been obliged to make a call upon the physician which the latter has had to meet. Perhaps I may say, without offence to my medical colleagues, that in the great majority of diseases not capable of surgical treatment exact diagnosis has little but an academic interest. Five and twenty years ago if a man had a tumour of the brain or spinal cord it was of no practical importance where it lay or what it was. But the moment that surgery can undertake to remove some of these tumours and thus to cure the patient it becomes absolutely