year 1685 as a time when "men died faster in the purest country air than they now die in the most pestilential lanes of our towns, and when men died faster in the lanes of our towns than they now die on the coast of Guiana." It is hardly too much to say that in the thirty-five years which have elapsed since Macaulay wrote these words, surgery has made even greater progress than in the one hundred and sixty of which he took cognizance, and the main outlines of this progress, in so far as they can be sketched without entering upon technical details, are of almost universal interest. The improvement of surgery means also an enlargement of the sphere of its influence, and at the present day there can hardly be a family to which this influence has not in some degree extended, or whose members have gained no practical knowledge of the steps and processes by which pain has been made to give way to ease, and by which dangers the most imminent have been replaced by comparative security.

It is never easy to frame an accurate definition; and the difficulties of framing such a definition of surgery would be almost insuperable. It may be roughly described as that branch of the healing art which aims at the restoration of health or the removal of disease by the direct application of mechanical means of treatment, such as the placing and maintenance of broken bones in a position favorable to their reunion, or such as the removal of diseased parts or of morbid growths by cutting instruments, caustics, or other suitable means. It differs broadly from medicine, in the restricted sense of the word, because medicine relies chiefly upon regulation of the diet and habits, and upon the administration of remedies, to the almost entire exclusion of mechanical methods. The distinction affords a sufficient basis for the separation of prac titioners into the two classes of physicians and surgeons; but the surgeon is compelled to be also a physician in a much stricter sense than that in which the physician is compelled to be something of a surgeon. People recover from fevers and such like systemic maladies without any surgical principles being brought into prominence during their illnesses; but no person ever recovered from a surgical operation without furnishing many illustrations of some of the first principles of medicine. However much it were narrowed down, the entire field of surgery would still be too wide to be even

glanced at within the limits of an article; and we therefore purpose to confine ourselves almost entirely to a brief narrative of some of those changes and discoveries which, having first relieved surgery from the reproach of pain, have now well nigh relieved it also from the reproach of danger.

If we set aside direct and necessarily fatal injuries to vital organs, the first peril to life which arises from a wound will be generally due to an inevitable loss of blood, a loss which will be rapid, profuse and dangerous in proportion to the magnitude and the number of the vessels which are divided, whether it be by accident or by the knife of the surgeon. It was long ago discovered that when limbs had sustained injuries of a certain degree of severity, there was no hope for the patient but by removing them; and the devices of ancient surgery for arresting the consequent bleeding were not only always barbarous, but frequently futile. The stumps were seared with hot irons, or dipped into melted pitch; and these methods, even when efficacious for a time, were often followed by fatal bleeding at a later period. The control of hemorrhage by applying ligatures to the ends of the divided vessels, first systematically practised by Ambrose Paré, about 1550, was the first step on the road which surgery has since traversed with such conspicuous success. So great a saving of life was immediately produced by Paré's method, that the French soldiers of his day are said to have gone into action exclaiming: "Our Paré is with us; we shall not die!" For three centuries after this there was no advance of similar importance, although individual surgeons attained high degrees of skill in the operations which, from time to time, were thought legitimate; although the researches of John Hunter paved the way for much of the best work which has been done by his successors. We may proceed without pause from the ligature of arteries to the discovery that the inhalation of ether would produce insensibility to pain. This discovery was made in the winter of 1846;* and its history has so lately been traced by Sir James Paget, in the Nineteenth Century, for December, 1879, that

* Comerford W. Long, M. D., of Georgia, discovered the use of anesthesia, March 30, 1842. See J. Marion Sims' History of the Discovery of Anesthesia.-(Eds. Med. Eclectic.)

it need not be here dwelt upon. Ether, the anæsthetic agent first employed, was at one time almost superseded in this country by chloroform, although the occasional mortality inseparable from the use of the latter has prevented surgeons from being at any time entirely satisfied with it. On account of the impossibility of finding out every case in which chloroform is administered, there is no absolute numerical certainty about the facts; but the best calculation which can be made, shows that out of every 2,500 or 3,000 persons who take chloroform, there will be one death distinctly traceable to its influence, and to nothing else. Many analogous substances, of which the best known is the bichloride of methylene, have been introduced as substitutes, with the hope of avoiding the mortality; but none of them have really afforded increased security, and some are attended by disadvantages peculiar to themselves. Of late years, however, the problem how to combine complete safety with insensibility to pain has been practically solved by a return to ether, which is manufactured of better quality than formerly, and the use of which appears to be entirely free from risk. There is no well authenticated instance of death from its employment; and in many parts of America, as well as in some London hospitals, it has superseded every other anæsthetic. An ample experience has shown that there is no kind of operation to which ether is not perfectly applicable; and the surgeons who chiefly use it do not hesitate to declare, that chloroform ought to be abandoned, and that no death produced by its inhalation can be rightly regarded as an accident.

The value of artificially induced insensibility, both as a means of saving pain and as a means of enlarging the boundaries of surgical activity, has been so well summed up by Sir James Paget in the article already referred to, that we can do no better than quote words. He says:

his very

"Past all counting is the sum of happiness enjoyed by the millions who, in the last thirty-three years, have escaped the pains that were inevitable in surgical operations-pains made more terrible by apprehension, more keen by close attention, sometimes awful in a swift agony, sometimes prolonged beyond even the most patient endurance, and then renewed in memory and terrible in dreams. These will never be felt again. But the value of the

discovery is not limited by the abolition of these pains or of the pains of childbirth. It would need a long essay to tell how it has enlarged the field of useful surgery, making many things easy that were difficult, many safe that were too perilous, many practicable that were nearly impossible; and, yet more variously, the discovery has brought happiness in the relief of some of the intensest pains of sickness, in quieting convulsions, in helping to the discrimination of obscure disease."

At the time of the discovery of the effects of ether, Sir James Paget had already been ten years a surgeon, was connected with a great hospital, and was rapidly rising in professional repute. He therefore speaks with the authority of experience about the nature and extent of the suffering which anaesthetics have banished, and which no man whose surgical memory does not go back for more than the third of a century has even witnessed. On this account, as well as from the weight which deservedly attaches to all his words, we will quote yet another passage from his essay-a passage especially noteworthy by reason of the lessons which it conveys.— London Times, March, 1880.

To be continued.

SOCIETY MEETINGS.

THE NATIONAL ECLECTIC MEDICAL ASSOCIATION-MEETING OF 1880.

By referring to page 459, October number, 1879, our readers will find the whole programme for the coming session, which is to be held in Chicago, June 16, 1880. A large meeting is anticipated. No doubt it will be one of the most interesting meetings held by this association.

STATE ECLECTIC MEDICAL SOCIETY OF INDIANA.

Abstracts from the proceedings of the meeting held at Indianapolis, May 12, 1880.

The president appointed as a board of censors, Drs. D. Lesh, D. P. Kennedy, E. Hubbard, C. P. Perry and C. H. Abbott, to whom the credentials and applications of persons desiring admission were

referred. The board reported favorably the following persons as having good credentials and being worthy: Drs. J. J. Burton, Royal Center; John L. Lehman, Fort Branch; George W. Hamsher, of Greenfield, and John A. Henning, of Red Key.

AFTERNOON SESSION.

The association was called to order at 2 o'clock p. m., and after roll call and the reading of the minutes of the morning session by secretary Pickerill, the president, J. B. Shultz, delivering the following

ANNUAL ADDRESS.

TO THE MEMBERS OF THIS ASSOCIATION: It affords me pleasure at this, the sixteenth anniversary of our association, to exchange congratulations with you, and in conformity with an established rule of this and all associations, I offer a few remarks, hoping they will be received in the same kindred spirit as administered.

An occasion of this kind should, and undoubtedly does, excite the deepest feelings of professional pride of which our minds are capable. I for one am quite willing to admit that it is difficult for me to express my emotion before a public audience. The thoughts that swell in my bosom are undoubtedly of the same form and pattern as of those with whom I am associated here to-day. You have not met here to-day as men who are just launching out in some untried fields, some new scheming enterprises, but as representatives of a profession that stands in front for all that is good and great. It requires no prophetic talent to insure a reward for our associated labors. And were it possible for me to do this, I would speak words that would have a tendency to impress into the minds of us all a truer and higher idea of our profession, and the associated conditions and benefits connected with it.

It is expected of us to be always ready to carry out the teachings we profess to have received, and to that end we should hold ourselves in readiness to maintain, by not only practice, but sound reasoning, the profession we have adopted. I trust that each member connected with this association will endeavor steadily to exalt the standard of professional and scientific attainment, to advance correct ideas, and elevate mankind, morally and intellectually, as well as physically. The purpose of our association is "to maintain