The functions and structure of parts are more frequently preserved
uninjured—mutilation is more rarely required—and operations are
dispensed with. The wider the extension of pathology, the fewer the
operations will be—thus affording the best criterion of professional
attainment. Who will question, that there is more merit in saving one
limb by superior skill, than in lopping off a thousand with the utmost
dexterity?
To treat surgical diseases as they ought to be treated, the
practitioner must be thoroughly acquainted with the healthy and morbid
structure; he must also have a mind vigorous and firm from nature, well
instructed in the best precedents, and matured by observation.
Years are not the measure of experience. It does not follow, that the
older the surgeon is, the more experienced and trustworthy he must be.
The greatest number of well-assorted facts on a particular subject
constitutes experience, whether these facts have been culled in five
years or in fifty.
It is only from experience, directed and aided by previous study, that
accuracy of diagnosis and celerity of decision can be acquired. Besides
knowing in what manner to proceed, the surgeon must know well wherefore
he acts, and also the precise time at which he should interfere. With
knowledge and confidence derived from experience, he will perform such
operations as are indispensable for the removal of pain and deformity,
or for the preservation of life, with calmness and facility—with safety
to his patient, and satisfaction to those who assist in, or witness,
his proceedings.
Attention to the apparatus is necessary. It should be in good order,
simple, and ample. The young surgeon should note down, previously to
an operation, whatever, on reflection, can possibly be required. "For
in most capital operations, unforeseen circumstances will sometimes
occur, and must be attended to; and he who, without giving unnecessary
pain from delay, finishes what he has to do in the most perfect manner,
and that most likely to conduce to his patient’s safety, is the best
operator."
It is seldom necessary to employ much preliminary treatment. From the
usual preparative course of bleeding, purging, cooling diet, etc.,
patients about to undergo capital operations, as lithotomy, suffer more
than they can gain.
It is of the utmost importance to attend to the state of the patient’s
mind and feelings. He ought not to be kept in suspense, but encouraged
and assured; and his apprehensions must be allayed. If this cannot be
effected—if he is dejected and despondent—talks of the great risk,
and of the certainty of his dying, it is better that the operation be
abandoned, or at least delayed. If, on the contrary, he is confident
in the resources of his constitution, and in the ability of his
attendant, and looks forward to the advantage to be derived from his
own fortitude, then should there be no delay.
Public-domain text, read in full here on John Shaqi.
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