patients? No. There is scarcely a good surgeon in this country but what has admitted in private and public that he has saved cases of general suppurative or infectious peritonitis. I picked up a medical journal to-day and saw an article in it by Dr. Hugh Taylor, of Richmond, an excellent surgeon, who cites a case of that character. He mentions two or three cases of perforation after a delay in operation of eight or ten hours. There is but one treatment for perforation, that is operation. The treatment is simple and usually successful. Some of the conspicuous men and women in this country have been saved after the fourth attack of appendicitis. One of the most conspicuous women in America, at the National capital, was treated one month in Chicago for appendicitis, and her case probably has been referred to in discussions before the Chicago Medical Societies as a recovery. She was moved to her mother's home in an adjoining city and treated for another month for appendicitis and her case reported as cured. One day, while at the national capital, she had a recurrent attack. I was called; I removed her appendix, and have it in a bottle, and she is now happy and in society. In conclusion, I might refer to those cases in which we have a suppurating right tube with the appendix fixed, and usually we remove the appendix when it is attached to a diseased appendage. I may say that in from six to ten per cent. of ugly suppurations of the right appendages, we find the appendix fixed and requiring removal. EMERGENCY SURGERY. BY NICHOLAS SENN, M.D., PH.D., LL.D., CHICAGO. I congratulate you on the first semi-centennial of your State Medical Society. The history of any medical society is always of interest, as it represents the birth and life of the society, the work done by its members, and the influence it exerted for good or evil in the respective community. A state medical scoiety is the embodiment of the profession of the state. It is composed of members of the profession who have been found fully qualified to constitute an organic part, and whose life and conduct inside and outside of the profession have been such as to entitle them to the recognition and privileges of a regular practitioner in good standing. The Georgia State Medical Society, born fifty years ago, has reached maturity. During its infancy, childhood and adolescence great events have occurred. It has witnessed history-making political upheavals. It has seen the Union endangered and permanently restored. Before it reached the first semi-centennial mile-post, the reunited country crossed swords with a foreign foe in the cause of humanity, and in less than three months dictated its own terms of peace and gave liberty to the enslaved people of three great islands held for centuries in the iron grasp of a crumbling monarchy. The last fifty years have been notable for the many important discoveries to which our country has contributed more than its share. As medical men we take a justifiable pride in what has been accomplished during the last half century in our profession. During that time medicine and surgery have undergone revolutionary changes. These changes can be seen to best advantage in comparing the text-books in either of these departments of the healing art of fifty years ago with those of to-day. The science of bacteriology is less than twenty-five years old, but it has done more for the advancement of medicine and surgery than the combined labors of all of our forefathers. Little was known of histology, normal and pathologic, fifty years ago. Examine the prescription files of fifty years ago and to-day, and you will be astonished at the advancements made in pharmacy, materia medica and therapeutics. Sanitary science has made wonderful progress since your society was organized. In the hands of competent obstetricians the puerperal woman passes through her ordeal with very little danger of infection. Less than fifty years ago puerperal fever claimed victims by the thousand annually, to say nothing of the sufferings and remote dangers of those who escaped with their lives from the lying-in chamber. Modern surgery was born thirty years ago with the studies and discoveries of the immortal Lister. Asepsis and antisepsis have shorn recent injuries of their greatest terrors and have rendered the surgeon's knife, judiciously and carefully employed, safe and beneficial. Under strict aseptic precautions the three great cavities of the body can be explored with little rest to life, their contents examined, and, if operable conditions are found, they can be subjected to direct operative treatment with good prospects of success. Pyemia, septicemia, and erysipelas, so frequently found in all of the large hospitals less than thirty years ago, are seldom seen now as wound complications. Hospital gangrene, the terror of large hospitals only a quarter of a century ago and which destroyed so many limbs and promising lives during the civil war on both sides, is never seen to-day. It has disappeared as a surgical complication. The different specialties have contributed much to the general fund of knowledge and towards the advancement of medicine and surgery. Georgia has always occupied a high position in statesmanship, warfare, the arts and sciences, medicine and surgery. Your State Medical Society, representing as it does the best elements of the profession, has done its noble share in the building up of American medicine and surgery. Many of your members dead and living are well and favorably known far beyond the limits of your state. Your transactions contain many literary pearls that will never perish. I am sure the objects the founders of your society had in view have been fully realized. It was in Georgia that the first steps were taken to unite the medical profession of the United States into an association. You are now celebrating your first semi-centennial; let your work and conduct be such that at the first centennial your successors on a similar occasion will look back to the first mile-post and the space between with the same satisfaction, reverence and esteem as we do now to the men and their work since the organization of the society. It would not be proper for me even to attempt to give an outline of the work you have. accomplished as a society during the first half century of your existence. This task legitimately belongs to a member of your society who has been indentified with the work and who is best prepared to act as your historian. The medical history of our country is a remarkable one, and the one who will relate to you the trials and triumphs. of your society from its infancy to vigorous manhood will tell you that your society has done its liberal share towards. placing the American medical profession, its literature and its educational institutions on a level, if not in advance, of that of any other nation. He will tell you that the time has passed by long ago when it was necessary for our gradu ates to journey to Europe to complete their education. He will tell you that our medical societies, national, state, county, district, and local, are doing, for what they are intended, most efficient postgraduate work. He will tell you that the better class of our medical journals are on a par, if not superior, to those of any other country. He will tell you that the American student reads in preference American text-books, and that our practitioners when in need of a silent consultant for good and substantial reasons consults works of reference written by American authors. Can the same be said of the medical profession of any other nation less than a century and a quarter old. As medical men we have every reason to be proud of our ancestors and their work; we have cause to be satisfied with what is being accomplished at the present time, and we are hopeful and confident of the future. In selecting a subject appropriate for this occasion, it was my intention to interest, and, if possible, profit the general practitioner. I ask your attention to a somewhat neglected, and yet in my estimation one of the most important, subjects that should command the keenest interest of surgeon and physician alike, viz.: EMERGENCY SURGERY. Emergency surgery may be defined as the application of manipulations or performance of operations in the treatment of accidents or life-threatening affections amenable only to prompt surgical interference. Emergency surgery is the surgery of the general practitioner. Every physician qualified to practice his profession should have the necessary knowledge and manual dexterity to perform at a moment's notice and with the simplest instruments and limited assistance all life-saving operations in all cases in which prompt action is necessary to meet the urgent indications. In large cities the medical practitioner can se |