The rapid advancement made in the pathology and treatment of surgical diseases demands a perpetual revision and correction of the systematic works devoted to this department of the healing art.
Accordingly, text books, various in merit and extent, have emanated from the different schools. Several of these have, by successive editions, kept pace with the science; whilst others have fallen into disuse.
In this part of Britain, the systems of Latta, B. Bell, and Allan, occupied the field; but it being now vacant, I venture to supply the deficiency, by reducing the heads of my lectures into a compendium, or guide, for those students who resort to this city.
It must appear superfluous to preface such a work by anatomical descriptions, anatomy being now studied more generally, and with greater zeal, than heretofore. Pathology also is more attended to, and better understood. To which circumstances are to be ascribed the improvements in surgical science, as well as in the art of operating.
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."