The elements of surgical pathology with therapeutic hints

Front matter

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UNITED STATES OF AMERICA.

THE ELEMENTS

Preface

The following pages have been written to present, or to attempt to do so — something systematic in the study of the etiology of morbid action, from the standpoint of one not in harmonv with very much of the teaching of the da}'. The current literature, as well as the text-books, assume so much. and are apparently so oblivious of the fact that there is wide diversity of opinion on this question, that something seems necessarv from the other side on this subject. The profession, may be divided into two classes, the clinicians, and the experimentalists. The students of the laboratory may certainly boast the largest following, but it is the worker in the clinic-room that must fix the seal of approval on the product of the former. None will be disposed to question that the technique of the laboratory cannot be carried out in the operating theatre: hence ideal results are impossible. But we find much inharmony among the bacteriologists. For instance, one among very many — Dr. Alexander Wilder, in the June (1895) number of the Metaphysical Magazine, has this to say on what he calls the " Microbian Craze:"—

" The notion that the atmosphere is forever swarming with germs of bacteria and other microbian products, ready to rush into wounds, into the lungs of every breathing thing, into our water and kneading troughs like the frogs of Egypt, and to enter the pores and through the stoppers of glass bottles, is purely a guess, without a solitary fact to sustain it, except such as are found in the interpretation wherein the guess is

VI

PREFACE taken as established fact. It is a plausible theory, but unproved. We are brought, therefore, to the conclusion inevitably: The germ theory is an assumption of causes, of the existence of which we have no evidence, to account for effects which they by no means explain."

It is impossible to present any adequate argument against the teaching of the laboratories, as far as it has to do with the practice of surgery — in a short essay, certainly" not with any approach to thoroughness. The attempt is here made, therefore, to cover the ground somewhat systematically, commencing with an account of processes that are on the border line between physiology and pathology, and studying the development of morbid action as something due to perverted function, assuming that conditions leading to inflammation are common initiatives to all pathological states. For this reason it will be necessary, for the reader to go through the book consecutively, one chapter being intimately related to that which precedes it. The introduction of " therapeutic hints" may be considered slightly incongruous in a work of this pretension, but the student may find them useful. In the preparation of the material much is due to the advice and assistance of friends and associates, to none more than to Dr. Samuel N. Watson, of this city. My thanks are also due, and most gratefully rendered, to my student, Miss Grace S- Stauffer, for much clerical labor, and invaluable assistance in correcting the proof sheets.

J. G. G.

Iowa City, Iowa, August ijtk. i8gj.

Table Of Contents

Preface v

Introduction i

The nature, and genesis of morbid action. Classification of morbid action.