Clinical Lecture ON THE PRINCIPLES OF CONSERVATIVE SURGERY,

1858 The Lancet  
SURGEON TO THE HOSPITAL. GENTLEMEN,-Conservative Surgery, as applied to large injuries, is founded on the principle of a greater than ordinary reliance on the resources of Nature, exerted to preserve and restore to its former condition of health and utility a limb, or any portion of the human body, which, in its absence, would be condemned to removal. Conservation infers a power to cure, and conservative and curative surgery are almost synonymous terms. The practice of curative surgery demands
more » ... wo eonditions-first, a thorough reliance on the inclination of Nature to preserve life and to regenerate impaired structures, and the power to accomplish the cure of injuries within certain limits yet untried by the observation and experience of the surgical profession; and, secondly, it involves the possession of certain moral feelings in the man himself. These two conditions are indispensable to a thorough investigation into the principles of curative surgery. In a decision to be formed on any given case, the surgeon must forget himself-he must forego the éclât attendant on great operations; his entire thought, his whole and concentrated interest, must merge in the welfare of his patient. Do not think I impute to our profession a moral weakness that is not common to all mankind. Term it a warrantable ambition-a desire for distinction, more commonly termed " notoriety"-an aspiration for greatnesswhatever it be, and in whatever degree it exist, it has a tendency to hamper the judgment, and to throw its influence into the scale of self-interest, to the prejudice of the person whom accident has placed in our charge for better or for worse. So long as human weakness is interwoven with human strength, :so long as the line which separates good from evil is finely drawn, so long will the tendency prevail. A man's conscience is the only arbiter. More influential still is the other condition, that Nature has the disposition to restore, in other words, to cure, to an extent beyond general belief; that her resources are larger, and that she is more liberal in the bestowal of them, 'than we are disposed by cursory observation to give her credit for; and that there is a "vis medicatrix" presiding over all diseases, palpable in all cases to the eye of the philosophical surgeon.
doi:10.1016/s0140-6736(02)70069-x fatcat:3ruqx3ckvvfohmc7jpmjgfr7z4