SURGERY (OF. eirurgerie, cirurgie, sirurgie, Fr. chirurgic, surgery, from OF. eirurgien, scrur glen, Fr. chirurgicn, surgeon, from Lat. chiral- gus, from Gk. xEyoury6s, cheirourgos), surgeon, handicraftsman, from xcfp, choir, hand fryov, argon. work). In contradistinction to medicine surgery embraces a consideration of those disease conditions that are treated chiefly by mechanical methods rather than by the ad ministration of drugs. This classification is nat urally arbitrary; and now that the dangers of surgical operations have so materially dimin ished, diseases formerly looked upon as hopeless or as suitable for medical treatment only are included among the surgical affections. It is incorrect, however, to assume that surgery con sists entirely or even in great part in the elabo ration of methods of treatment; the pathological processes so treated demand and receive their proper degree of investigation and study.
Up to the time of Hunter (172.8-93) surgery, and indeed medicine, were based in their practice almost entirely upon tradition and dogma. 1-hin ter, by his labors in the direction of anatomy and physiology, lifted medicine from the ob scurity of philosophical doctrine to the firm foundation of facts and imparted an impulse that is still felt and is still in evidence in the meth ods of research employed to-day in the fields of comparative pathology ,and experimental medi cine which promise most for the advancement of the medical and allied sciences. With Hun ter's death, however, ended the active prosecu tion of original investigation; and although the high position of English surgery at that time was preserved by the clinical and other work of Hunter's successors, notable among whom are Charles Bell, Astley Cooper, Abernethy, and Jen ner, the laboratory methods employed by him were largely abandoned and have only within relatively few years been revived. From Hun ter's period to the introduction of anesthesia there is no remarkable fact in the development of surgery. During this time the efforts of sur geons seem to have been directed chiefly to the perfection of the bedside methods and the in fluence of the profession in America began to make itself felt. Ephraim AlcDowell, a native of
Kentucky and trained under Bell in Scotland, in 1809 first successfully opened the abdominal cavity and removed an ovarian cyst, thus estab lishing forever one of the most beneficial of op erations. A little later Valentine Mott of New 1o•k successfully applied ligatures to some of the largest arteries, for the relief of aneurism, and demonstrated the curability of this disease in positions in which it had previously been in variably fatal. The introduction of general antes thesia (q.v.) in 1846 by Warren in the Massa chusetts General Hospital marks the greatest stride in the progress of surgery up to that time. This property of ether was discovered inde pendently by Long of Georgia and Morton of Boston, but it remained for Warren to popularize it by making use of it publicly, repeatedly and with success. A year later Simpson of Edinburgh introduced chloroform. The propulsion to the practice of surgery given by the employment of general anesthesia during operations can hardly be exaggerated. Before that time operative treatment of disease was limited in its application to lesions correctible by coarse methods and in briefest time. Human beings, surgeons and pa tients, could not endure the pain of protracted operations, nor could sufficient freedom from struggling be secured to make refined dissections possible. Under the influence of anesthesia quiet was obtained and the necessity for great speed was greatly diminished, so that new operations were soon planned, new regions invaded, and de tailed procedures devised and new and better results achieved. Even after the introduction of anesthesia, however, operations and all open injuries continued to be looked upon with dread, for they were almost invariably followed by one or the other of the infectious wound diseases, and deaths from septicemia, tetanus, hospital gangrene, etc., were so common that the mortality after even trifling operations was not small.