If we have been too professional in this discussion, we plead, as an apology, that in no one point in the whole range of surgical practice would unnecessary suffering be avoided more frequently than on the subject before us; provided only that what is clear and positive, as distinguished from what is conventional and erroneous, were once popularly familiar; for, amongst other evils, most of the operations in this department of surgery are not only superfluous—to use no stronger term—but they practically interfere more than any one thing whatever with the progress of the scientific investigation of the nature of these maladies.
The removal of them by operation is too commonly undertaken, not only under circumstances which, as Abernethy said, "add cruelty to calamity," but for reasons which logically forbid such a proceeding; and although there are conditions which call for such interference, yet those under which it is usually instituted help only to obscure the real relations of the disease, and to throw the shadowy veil of an irrational empiricism over the operations of nature.
Those who recollect the remarkable results which Abernethy sometimes obtained in regard to this intractable and often formidable class of diseases, will, I think, be disposed to agree in thinking that few maladies are more open to improved investigation, or promise a more encouraging prospect of enlarging the boundaries of philosophical medicine.
SECTION.
HIS PAPER ON A CURIOUS CIRCUMSTANCE SOMETIMES
FOLLOWING INJURY TO THE LUNGS.
Fractured ribs are common accidents, and illustrate very beautifully those conservative principles in animal bodies which give such interest to the study of their economy.
When first we consider that the ribs form the greater part of that box in which the lungs and heart are enclosed, and by which they are protected, we are disposed to regard a fracture of one or more ribs as a very serious affair.
Nevertheless, these accidents generally do extremely well. In the first place, the gristles, or cartilages as they are called, by which the ribs are attached to the sternum in front, give, in conjunction with the spine behind, considerable elasticity to the whole structure of the chest. Most injuries have therefore to overcome this elasticity, before anything gives way; and when the rib has done so, and is fractured, the resiliency of the cartilage or gristle to which it is attached tends to restore it to its place, or to set it, as we phrase it.
Another very curious thing in accidents is the instantaneity with which muscles which are ordinarily under the dominion of the will, become reluctant to obey it, or altogether repudiate its authority. In all fractures, of course, the most material thing is absolute repose; and there is very little chance of a man moving his rib when it is broken. He instinctively begins to expand his chest, for the admission of the necessary air, by other muscles, usually to the exclusion of those which are attached to the broken bone.