The trained nurse has fortunately come to stay. In fact, our antiseptic methods as above described have made the trained nurse indispensable. The old nurse, who, by many clumsy experiments on her patients, had obtained a certain rule-of-thumb knowledge of the care of the sick, can no longer assist in a surgical operation or properly care for any surgical patient. The modern nurse must of necessity be a well-educated, well-trained woman, knowing thoroughly modern antiseptic methods, and on the alert to observe every symptom of improvement and every signal of danger. Without a well-trained nurse it is impossible at the present day properly to care for any serious surgical case, and I gladly bear witness to the intelligence, fidelity, and skill of scores of nurses who have assisted me, and without whom I should have felt as one blade of a scissors without its fellow. SPECIAL OPERATIONS _Amputations and Compound Fractures._—Having now traced the different modes of thought which have aided surgical progress in the nineteenth century and the improved means of investigation, let us turn finally to the progress in individual operations. As to amputations and compound fractures, I have already indicated the immense improvements which have followed the introduction of anæsthesia, and especially of antisepsis, which have brought the mortality of amputations down from fifty or sixty per cent. to ten or fifteen per cent., and in compound fractures, once so dreaded, since the mortality was not infrequently as high as two out of three, to a relatively insignificant danger. _Tumors._—In no department, perhaps, has the introduction of antisepsis, and the use of catgut and silk ligatures after the antiseptic method, brought about a greater improvement than in operations for tumors. The startling reluctance of Sir Astley Cooper to operate on King George IV. for so simple and small a tumor as a wen, lest erysipelas might follow and even destroy his life, is in marked contrast with the success and therefore the boldness of modern surgeons. Tumors in all parts of the body, whether they be external or internal, whether they involve the wall of the chest or are inside the abdomen, are now removed with almost perfect safety. Anæsthesia has made it possible to dissect out tumors in so dangerous a region as the neck, where the surgeon is confronted with adhesions to the jugular vein, the carotid artery, and the nerves of the neck and of the arm, with the greatest impunity. Such an operation not uncommonly lasts from three-quarters of an hour to an hour and a half, and involves often the removal of two or three inches of the jugular vein and many of the large nerves, the removal of which a few years ago would have been deemed an impossibility.