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of the State of Wisconsin." Up to the year 1854 the membership was small, being limited by the by-laws to the admission of two new members annually. Delegates from local medical societies were received as such in addition to its regular membership. At a meeting in that year this restriction was removed and its portals opened to larger membership and probably increased usefulness. From 1861 to 1867 its work was suspended, but when the war clouds had fairly cleared away, it again resumed its accustomed meetings. · From its thirteen founders it has grown until it now numbers more than two hundred active and honorary members.
The professional work in our Territory and State since the birth of our Society has for the most part been quiet, and little of it has been known to the world at large. Yet, while we cannot point to a McDowell, a Sims or a Gross, we are conscious that much that is excellent, and even brilliant, in both medicine and surgery has been accomplished.
This span of time has encompassed marvelous changes in our profession. Probably the most important and valuable progress lies in the keener appreciation of our wants, and the consequent searching of hitherto untrodden paths to storehouses of knowledge. We are to-day learning that this great problem of life, both in its simple existence and also with its multitude of modifying surroundings may best be learned by a careful study of its lowest forms, and the gradual development from the simplest to the most intricate. By this new and normal method of investigation we have reason to expect much of truly scientific acquirement. More and more attention is given to the study of microscopical anatomy, and the more obscure and finer physiological processes, as being the necessary stepping stones to a clear understanding of that at first, but slight deviation from the normal, the pathological. The advances in pathology, and in the methods of investigation have been vastly important. Koch's announcement of his germ theory of disease, while the tests of time, searching study and calm judgment have not yet determined its intrinsic worth, is yet one of the most brilliant efforts of modern times.
With these advancements in the knowledge of anatomy, physiology and pathology we should rightfully expect better diagnosticians; and in this we are not deceived. Where our special senses are incompetent, we call to our aid the microscope, the stethoscope,
the thermometer, the sphygmograph, the ophthalmoscope, ästhesiometer, the aspirator and the electric current. The individual in the profession is becoming broader, and his individuality decidedly more prominent. He considers more attentively the external conditions and surroundings which may bear upon his work, more thoroughly scrutinizes existing theories of disease, searches for generations back perhaps to secure greater accuracy of knowledge, and possesses much more intelligence in the use of accessories to diagnosis. With the advances in diagnosis and the understanding of disease, prognosis must necessarily have reached greater precision. Chemistry and experimental therapeutics have made material and valuable advances in searching out and separating the wheat from the chaff, in giving us greater certainty and elegance in the use of remedies, in discovering new and valuable ones, and new uses for those already known.
One triumph in this field achieved within the existence of this Society rivals any discovery in the history of medicine. I refer to anästhetics. The value of anæsthetics in alleviating human suffering, the pain of vivisection, and in saving life is simply beyond computation. And what more can be said of any discovery to aid the advancement of surgery than that it places the limit of all possibilities in surgery simply within the capacity of the operator's skill, without stint as to time desired for the operation and with the quietude of sleep.
Much progress has been made in determining the nature and application of antiseptics, and the worth and proper use of antipyretics. We are to day questioning with far greater exactness the nature and action of all remedies which we command in time of need.
For the most brilliant volume in the history of the progress of these times, we turn to that of surgery. Some time since surgery had so far perfected itself that not a few intelligent men regarded its climax as already attained. But the valuable advances made yearly admonish us that its grand summit may yet be, to us, above the clouds.
To-day no little sufferer from deforming diseases of the spine is too poor, and it is to be hoped that no community possesses a physician so destitute of knowledge, as to forbid his enjoying the benefits of the gypsum jacket. Much improvement has been made in the mechanics of the various kinds of deformity apparatus.
So much that the knife is now much less frequently used, and the results achieved by ingenious mechanism, intelligently directed, far surpass those of years gone by.
Electricity is now commanded to illuminate the by-places and to aid in making many incisions which the scalpel alone dare not undertake.
The aspirator renders most valuable service in the treatment of pleuritic effusions particularly, and effusions within serous cavities generally, aiding largely in both the saving of life and deformity. In litholapaxy Bigelow has most signally forwarded the solution of the problem of the safest and best means of removing certain forms of calculus from the bladder.
Vesico-vaginal and uterine and recto-vaginal fistulæ, among the most obnoxious of all, in the line of human ailments, required but the skill of a Sims to banish from the list labeled, defeat in surgery. The full appreciation of a lacerated cervix, and the almost unvarying relief to be obtained, is a most important advance, and stands a monument to its discoverer. Cystotomy has been done for the relief of chronic cystitis.. Porro's operation has made an advance on Cæsarean Section, and this has again been improved by Thomas' Laparo-Elytrotomy.
Perhaps the most marvelous advances are in the field of ab. dominal surgery. The results of the various operations requiring the invasion of the abdominal cavity excite both wonder and unfeigned admiration. Ovariotomy, Oophorectomy, and Tait's operation are so successfully accomplished with the modern advances in surgery, that their adoption is no longer a matter of extended argument, but hailed as a grateful reliet from misery and premature death. Almost without exception have the viscera of the abdominal and pelvic cavities been assigned to the field of operative surgery
With more or less success have both cardiac and pyloric orifices of the stomach, been operated upon for both benign and malignant constrictions, the duodenum has been provided with a new and artificial connection, and foreign bodies have been successfully removed by abdominal section. The intestines have been successfully resected when a portion has become destroyed, wounds have been closed, foreign bodies removed and intussusception relieved by operation. Whenever disease or accident calls for it, the gall bladder is opened, and the liver and pancreas invaded and perhaps partially removed. Splenectomy and nephrectomy are numbered among the brilliant achievements of surgery. Purulent accumulations within the abdominal or pelvic cavities are no longer shunned by virtue of their abode within these walls, but intelligently and boldly treated by the laws governing abscesses generally. Hysterectomy has become under certain conditions an established operation. So familiar has surgery become with the abdominal incision that it is now adopted by our best operators purely for the purpose of exploration, and diagnosis in obscure conditions.
All operations on these regions antedating the period under consideration have been greatly improved or cast aside by the modern experiences.
In ways too numerous to mention here, have all the specialties in medicine made important advances. One of the most, if not the most important, of all the aids which have made these marvelous advances possible, remains to be mentioned : viz: Listerism. While Listerism cannot be said to be generally accepted in its purity, Lister has defined cleanliness in surgery and projected means for securing and maintaining it as has no man who has lived before him. Whether we accept his theory or not, the fact remains, that since his famous successes, the worth of at least thorough cleanliness, and its necessity for the good behavior of wounds, has had world wide and thankful recognition. To these advances and to others too numerous to mention on this occasion, yet of sterling worth we turn with feelings of just pride and humble thankfulness. To these modest acquirements we cast a glance in the hour of defeat for some morsel of encouragement, that we may again battle against the victor. How great the need upon those occasions when death stalks on as if the medical profession had never existed, and desolation seems to surround us, no one but he who has experienced such occasions can comprehend. That there are grave responsibilities resting upon us in the great work of the profession needs no argument for proof. Are we to-day modestly, intelligently, honestly, boldly and vigorously doing our whole duty in promoting the best interests of our noble work? Are we keenly alive to the measure of
what is resting upon us individually, and to the farthest limits of our relations to the profession in the matter of its growth in knowledge, integrity of character and honorable preferment?
Our greatest hopes for healthy growth in all these essentials lie in the direction of increase of knowledge. We are without exception demanding that more time be given to medical study. We firmly believe that our Medical Colleges should extend their courses of study and require more thorough examinations before granting their diplomas. Their reply is that the students demand what they are giving them, and that competition compels them to maintain a standard for graduation which is far too inferior. More than this: with very few exceptions no preliminary examination at all is required for admission to the study of medicine, or a farce is enacted which does not in the least tend to improvement. The result is an intellectual condition on the part of myriads in the profession which serves to blot its honor and obstruct its proper advancement.
There is a remedy for this state of things, if properly administered, far more certain to reach exact and beneficial results than most of those at command in our daily practice. That remedy and reform, like all great, thorough and true reforms, lies with the individual.
We shall take for granted that no student undertakes the study of medicine, without first advising with some practitioner. Right here the great responsibility lies of properly directing the twig, that the tree may assume a stature of strength and beauty of proportion which is becoming to our important science and art. He should be made to understand that too much culture cannot be attained by the student of medicine; that it is not only advisable, but absolutely necessary that he should have mastered at least the requirements of a high school education, and the more added to this the better, before commencing his professional studies; that as the new avenues of research are opened up, and the vastness of the field before us becomes yearly more apparent, the necessity for far more extended study becomes largely increased. Let him clearly understand that the wisest of the world's physicians thus far have become possessed of but an unsatisfactory and disappointing portion of the wealth of medical lore.
Too much stress cannot be laid upon this important matter. The general standing of our profession is too well understood to