The Dominion SATURDAY, OCTOBER 4, 1918. DOCTORS ANCIENT & MODERN.

Dominion, Volume 7, Issue 1872, 4 October 1913, Page 4

The Dominion SATURDAY, OCTOBER 4, 1918. DOCTORS ANCIENT & MODERN.

There is no doubt a widespread feeling that tho modern surgeon is too Fond of operations, but tho wholesale attack on ' tho medical profession by Dean Darby at Hamilton on Sunday last should not have been mado unless it can be supported by very convincing evidence. One would like to know tho preciw grounds on which ha bases the assertion "that the present modico was a prospector armed with tools to bore inside his fellow-men, while women were rolled to the operating theatre as to a bijou show." Tho Dean aJso states plainly that it is simply a question of money, and that doctors know that once tno knifo has been in a patient he will return. Sweeping assertions of this nature are liable to do a good deal of harm in tho influence they havo on tho public, quite apart from tho injustice they may do the medical profession as a whole. It is truo that the Dean has since stated that he has numbers of actual cases with all tho necessary data which I could be Ruotod in confirmation of

his assertions; but tho valuo of such evidence cannot bo weighed until it is produced, and in any case it is extremely difficult for a layman to judge whether any particular operation is necessary or not. The great changes that havo occurred in surgical practicc during recent years wcro referred to by Sir William Watson Cheyne at the recent International Mcdical Congress. He said improvements and advances wore constantly being made, and tho recent researches on tho prevention of shock opened up the possibility of further largo extension of tho art. He wondered what would bo tho state of surgery when the Congress next met in London 1 Tho remarkable feature at tho present time was the leading place which it had taken as the chief curative measure | in a great variety of diseases which were formerly looked upon as belongI ing to the domain of the physician. Would surgery still maintain this predominant position, or would mcdicine havo regained Bome of its lost ground 1 It seemed to hira that the latter view was very probable, and that in the case of tho various infective eonditions l at least, surgery would by that timo have yielded to less severe measures. After all, tho cure of disease by removing large portions of tho body was a very drastic procedure, and could only, in many cases, fill a temporary place till means were found to cure tho diseased tissues rather than to remove them. Sir William Oheyne's remarks give support to the belief that there has been a tendency in rccent years to uso thof knifo too freely, and he indicates that a reaction is now setting in; but he would probably bo amazed to read Dean Daiiby's lurid picture of the modern surgeon and his ways. But however much we may welcome the assurance of such an eminent authority that medical opinion and practice show signs of returning to less drastic methods in the cure of disease, that is no reason why we should withhold our admiration for the splendid achievements in surgery which have occurred since tho days of Lister, who must always be regarded as one of the world's greatest benefactors. The papers read and the demonstrations given at the International Medical Congress enabled even a layman to realise in some measure ■ the marvellous

triumphs of the present generation in this branch of the healing art. Sir Thomas Barlow was not using extravagant language when he declared that "wo aro staggered by tho reasoned and calculated audacity" which charactcriso sorao of the operations which aro now successfully performed; and ho went on to say that "the supremo gain after all is • that many more useful lives are saved than in the last generation, that the realm of grave and hitherto incurable disease is invaded on every side, and that the danger of opera-

fcion, qua operation, is retreating to a vanishing point. A practical demonstration of one of tho wonders of surgery was given to members of the Congress by Dr. Albue, of New York, in tho form of an operation which ho has performed nearly 150 times for tho euro of tuberculous disease of the spine. A strip of bono is out from tho ahinbono of the patient and fixed firmly by stitches to a groove cut in tho Dackbone. This bone grows into its now position and becomes ultimately' part of tho spinal column. "Tho operation was performed with .complete success," says The Times, "and there is every prospect that the little boy of three-years of ago, who was the patient, will make a good recovery." One cannot help feeling a certain amount of,. sympathy with Dean Darby's suggestion that wo should hark back to the Bimplo remedies used by our fathers; but this sentiment dwindles away in the light of facts. There is a widespread inclination to idealise the good old times" that havo passed away, for distance lends enchantment to the view; but as a matter of plain fact the treatment of discaso by means of the "simple remedies used by our fathers," when seen at close quarters, was only too often anything

but enchanting, and when judged by results it fell far Bhort of modern scientific • methods. Compared with our - own times tho death-rate fifty years ago was alarmingly high, and this is really the decisive test. What the newer methods in medicine, surgery, and sanitation have accomplished is strikingly shown in the following facts and figures recently quoted by Mr. John Burns, M.P., President of the Local Government Board, comparing tho average experience of England and Wales in the three years 1901-11 with the averago experience of 1871-80; — In the three years 1909-11, 1,529,060 deaths occurred in England and Wales. This number was 772,811 fewer than would have occurred had the average doath-rate of 1871-80 held good for these three years. The largest share of this saving of life during three years occurred in the working years of life, and the gain thus secured to the economic capacity of the nation was on a gigantic scale. Comparing the aggregate experience of the three jears 1909-11 in England and Wales with the experience of three years based on the average death-rato for the decennium 1871-80;- " Persons. Tho saving of life in these 3 years at ago o—l was over 98,000 „ „ i—s ,; 120,000 5-18 „ 41,000 „ 15-25 „ 58,000 ~ ' „ 25-35 „ 78,000 „ ■„ 35—45 „ 77.000 „ „ 45—55 „ 50,C00 „ „ „ 55 & over „ 114.000 Taking the whole of- tho thirty-two years, 1881 to 1912, and considering the saving of life during this period, the figures are truly colossal. During these thirty-two years, in England and Wales 17,083,751 deaths occurred. ITad the relatively high death-ratc3 of 1871-80 continued during each of these thirty-two years with tho populations of each of these years 3,942,000 more deaths would havo occurred than were actually experienced. Whatever may be our sentimental regrets at the disappearance of some' time-honoured ideas and picturesque personalities from tho world of medicine, we havo good reason to be thankful that, to quote Lord Morley, "the old-fashioned . apothecary of the novels has given place to a scientific man who holds his head as high in tho Bocial hierarchy of the world as tho lawyer or the divino."