yielded most excellent results. Indeed it may be said that in consequence of this treatment the "failures" have been reduced to a minimum. In former days the great source of anxiety to a surgeon was whether or not an eye, after a cataract extraction, would suppurate. Just in the same way as wounds of other parts of the body almost invariably suppurated, so after operations upon the eye suppuration was a common occurrence. But suppuration meant of course destruction of the eye, in other words, failure of the operation. For the most part, when this untoward result occurred, the cause was attributed to some pervading unhealthiness of the patients at the time of the operation. In some cases their blood was said to be "weak;" on the other hand, it was held that the patients could afford to part with some blood. The following quotation will show how divergent were the opinions on this matter. A very distinguished author wrote in the most popular text-book of his time (1838), that

it rarely happens but that the operation of cataract is followed by such a degree of in flammation in one or other of the textures of

the eye as to require the abstraction of blood from the system. So well established is this observation that some make it a general rule to bleed the patient at the arm in the course of the first twenty-four hours after the opera tion, whether the pain is complained of or not.

To comment seriously on this line of practice would not be fair. The day is past when this treatment was held to be necessary, and time could not have effected a kinder service for sufferers from cataract. The suppuration of an eye after cataract extraction is now known to be an infective process, that is to say, to be due to the inoculation of the wound with pathogenic micro-organisms. By means, however, of strict adherence to the principles of antisepticism, no infection can take place consequently suppuration does not occur, and one of the greatest sources of failure of the operation has thus been effectually banished.

In this outline of " Modern Surgery" I have only dealt with those topics which, without being too technical, have appeared to me to illustrate the

subject best. Over and above, however, all that has been mentioned, there remains a mass of facts which could not be discussed in these pages. Probably, no interest could be derived from merely citing here technical details to which the facts would mainly refer. Nevertheless, quite possibly if the public were able to look a little behind the scenes of medical life, and with an intelligent appreciation grasp effectually the full meaning of the advance of surgery within recent times, there would be much which could not fail to excite their admiration. The reproach which used formerly to be cast upon surgeons, that they were mere practitioners of the art-if so it may be called-of butchery, is now never raised up in judgment against them. There is, indeed, as much difference between the operative surgery of the present day and that which was practised in olden times as there is between the finished work of an Academy picture and the pristine daub which used to do duty for the sign of the village alehouse. As a matter of fact, no true comparison can be drawn between ancient and modern surgery-the difference is so vast. On the other hand, a useful comparison can be made between modern surgery and modern painting. Probably the fact has never been fully appreciated, that a successful operation in surgery is just as much a production of art as is a picture whose excellence has gained for it the honor of purchase out of the Chantrey Bequest. The subtle touches of the distinguished painter, which call forth admiration for his work from expert critics, freely find their counterpart in the deft procedures of the skilful surgeon which bring to a successful issue a well-conceived and difficult operation. The painter, however, will always have the advantage of the surgeon in the practice of his art. The former has always the opportunity of making good any defects which may have arisen in his work, while the latter can never forget that he has Nature to reckon with whenever he makes mistakes. For the most part, Nature is a kind mistress, and displays a kindly disposition to surgeons. Nevertheless fickleness is one of her features, and occasionally

.

surgeons are forcibly reminded of this inexorable fact by the havoc which is made of their work.

A man to be a good surgeon must be a good "artist," that is to say, he must be born with the instinct of his art. The knowledge and experience of his profession will never reach full fruition unless this be the case, nor can we expect the art of surgery to progress as an art without the aid of those who are instinctively surgeons. In former days it was thought that no one could claim to be a good surgeon who was not a brilliant operator. But brilliancy in operating is now one of the last features which surgeons make any effort to cultivate. Obviously, in the interest of a patient, a brilliant operative display can be but of little value. An operation brilliantly performed is by no means the password to a successful result. To onlookers perhaps the display would excite admiration, and might even lead to the operator being congratulated, but the applause might nevertheless prove in the end to have been gained at the price of the patient's life. Thus with a view to his results a surgeon nowadays finds it most expedient to proceed deliberately with his work. No hurry, no No hurry, no effort to appeal to the admiration of spectators, no thought beyond the good of his patient, can be admissible in the practice of modern operative surgery. The reason for this is obvious-the ubiquitous microbe, ever ready to destroy the surgeon's best work, cannot lightly be disposed of, its evil presence is ever hovering around him while operating, and thus, of necessity, caution must be the watchword of the proceedings and brilliancy be supplanted by deliberateness. But the art of surgery must not be measured merely by its display in connection with operations. The mention of this matter recalls another fallacy with which the practice of surgery was formerly associated. The impression was at one time almost universal that a surgeon and an operation were convertible terms that is to say, that a surgeon never lost an opportunity of operating, even regardless of the necessities of the case. However in former days the practice of surgeons may have justified this

opinion, it is only true to say that no such reproach can now be urged against their successors. For, in truth, some of the best examples of modern surgical art are to be found among those cases in which the surgeon has deliberately refrained from operating, or has, in the place of a radical operation, performed one of a modified type with the utmost advantage to the patient. Some thirty or more years ago, the late Sir William Fergusson introduced the term "conservative" surgery to professional notice, and since then a new principle in the art has come to be established, making it imperative among surgeons to avoid as much as possible radical measures in all cases in which modified procedures give prospect of success.

conserva

Presumably it is quite unnecessary to point out that the terms tive" and "radical" as used in surgery are entirely without any political significance. In times, however, of general elections their use by lecturers on surgery are not usually allowed to pass without notice by the medical students. Perhaps I may be permitted to mention an instance in point. During the course of the General Election in 1874, when the banner unfurled by the then Mr. Disraeli was instrumental in gaining many seats for the Conservatives, an eloquent lecturer on surgery happened to have for his theme the treatment of diseases of the joints, during which he referred to the advances which had been made in the results by the introduction of the principle of conservative surgery. Doubtless he found himself unable to dissociate the term "conservative" from the political events which were then absorbing the attention of the whole country, and it seemed, therefore, quite natural that he should describe the principle, reintroduced by Sir William Fergusson, as due to a conservative reaction." the mention of these two words had an electric effect upon his audience, for five minutes at least the walls of the sombre anatomical theatre resounded again and again with the cheers of the enthusiastic students. Utter amazement was depicted upon the mobile features of the lecturer at the tumult which he had thus unwittingly raised. He paused, made a vain effort to re

But

commence his discourse, raised his hand deprecatingly, and at length began to show signs of displeasure. But all to no purpose; the students determined to have their cheer, and they had it. When silence was restored, he sagaciously remarked: "Well, gentlemen, upon this occasion, I apprehend that you will not require me to discuss the question of the radical' cure"-a happy sally which was fully appreciated. The great aim and ambition of the modern surgeon is to have good results, and no demonstration is needed to show of what paramount importance this ambition must be to his patients. Obviously the better are the results the greater must be the benefits derived by those upon whom his art is practised. In taking every effort to reduce the mortality from his operations, and to bring relief successfully to his patients,

the modern surgeon has an infinitely more responsible and difficult task to perform than was the case with his confrères of an earlier age. A successful surgeon of the present time must in his way be a man of considerable scientific attainments-that is to say, his acquaintance with the collateral sciences of medicine and surgery must to a large extent be on a par with his knowledge of that special branch of the profession to which most of his attention has been devoted. In the salutary competition, therefore, which exists for good results, humanity profits most. After all, "by their fruits ye shall know them," is an expression which is fairly applicable to surgeons and their work; a surgeon's results are to a tolerably trustworthy extent an index of his capacity and value.-Nineteenth Century.

YES (said Colonel Travers, as he lit his cigar), I got my first lift in the service by the Ashanti war. I began soldiering in the old 150th in England, but it was a case of the earthenware jar swimming with the brass pots. The life was delightful, and my comrades were the best of fellows. But the pace was rapid. They could stay. I could not, and was soon hopelessly out of the running and stone-broke. There was only one resource left, and I took it. Cox arranged an exchange to a West India regiment, and I found myself, in rather a woful frame of mind, on my way to Sierra Leone. Fortunately I had got my company before exchanging; so I lost nothing of promotion, and I hoped somehow to get back to European service if better times ever came. I found the West Coast of Africa an awful place; but I did not drink, and always lived a tolerably steady life, so, beyond a few acclimatizing attacks of fever, I was never really ill, and was not by any means miserable. I had rather a turn for

languages, and devoted my spare time to the study of the Coast dialects, with which I became fairly well acquainted. I little knew how well this knowledge would stand by me in the near future. When the Ashanti war broke out, and Sir Garnet Wolseley with his staff arrived from England, trustworthy interpreters were at a premium, and I found my services eagerly sought for at headquarters, where I had thereafter pretty constant employment. Sir Garnet Wolseley never forgets men who have served him well, and I got my brevet after the war, and have been well looked after ever since. I dare say you have all heard of Obeah, the black art among the negroes, which is closely allied to Voodoo worship. I will tell you a story of some curious episodes of the campaign which came particularly before me, and when you have heard it, you may believe in the existence of Obeah or not, as you like.

It was near the end of December when I was one day summoned to Government House at Cape Coast Castle to

interpret at the examination of a woman who had offered to give information about the enemy, who had been lately driven out of the Protectorate, and of whom our scouts had temporarily lost touch. As soon as I arrived at the chief of the staff's office, she was brought in by an English orderly sergeant. She was a tall old woman, and had not the black skin of the coast tribes, but her bronze color told of the mixture of blood from a higher race, probably that of the Moors, who have worked their way as traders from the north of the continent toward the west. Her features had not the negro coarseness, but were strong, bold, and almost classical. Her figure was swathed in a voluminous white robe, and only her beautifully moulded arms were seen, one of which was encircled by a plain bangle from which hung two of the mysterious Aggry beads, so rare and so much valued in Africa. A red cloth was rolled round her head, the end of which partly covered her face, and was only thrown back when she talked. She leaned upon a long carved native staff, and, as she entered, looked round the room with the proud demeanor of one who was the chief person in it. In the bare whitewashed apartment, with its tables covered with papers and writing materials, and the few Windsor chairs which mark a Government office in all parts of the world, she was a sufficiently striking personality, and very much in contrast to the English officers in whose presence she was.

The chief of the staff had been busy dictating to a young fresh-looking man who had just come out on special service, and whom I did not know; but, when I came in, he turned to me and said, "Glad to see you, Travers. This old party has just come in from the enemy's direction, and I am told she has something she wishes to tell us. Will you kindly examine her, and see if she can give us any information."

There was something so dignified in the woman's appearance, in spite of the poverty and simplicity of her clothes -something so far removed from the squalid animalism of the natives that we generally saw-that I almost involuntarily adopted a friendly and nearly respectful tone in addressing her.

"What is your name, mother, and where do you come from?"

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My name is Ahima, and I come from Mampon way. My husband was a great chief, but he is dead. My daughter was married to Chief Quabina, but she was killed by the king's order at the Adai Custom. I wish the king to suffer, and I am here to help the white soldiers."

When I had translated this, the chief of the staff said, "This sounds very plausible, and I am inclined to believe what the woman may tell us. Go on and ask her where the king's army is now, and what it is doing.'

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"I left the army beyond the great river," she replied. They have made a camp there, and many chiefs havo brought their men. They have fear of the white men; but they say that the great water and the big smoke canoes are their fetich, and that, when they leave their fetich, they will not be able to fight against the king's warriors. They are fools, and the king will find that the white man's arm is long, and I am here to tell all things that may make it strong to strike, that my wish may be fulfilled against Ashanti."

"The old lady is pretty vindictive," said the chief of the staff. "It is a pity that all the people whose relations the king has murdered have not the same feelings. We should have no trouble in smashing him. Let's make the most of her, however. With that he proceeded, through me, to put a series of questions about the names of the Ashanti chiefs, the number of men that each commanded, the way they were armed, and the description of the roads and towns which lay between the coast and Coomassi.

To all the questions she gave most clear and precise answers, and never since the war began had the intelligence department been furnished with so much valuable information. When the interrogation was at an end, and everything she had said was written down, she turned to me, and, raising her hand like some prophetess pronouncing doom, said, "Tell this also, that the time of vengeance has come. The dark powers will work against Ashanti. Its army will fall, and there

will be an end of its strength. I am old and poor, but I can do more than the white man thinks, and I shall be with his warriors to help them wherever they go. If the white chief wishes to know anything, I shall be there to tell him, and the men of Ashanti shall sorrow to see my face." As she pronounced these words with emphatic gesture, she stood in the full glare of the African sun, which streamed through the window, and her long dark shadow fell athwart the room. The young officer who had been writing sat behind her, and the shade fell upon him. As she ceased speaking she looked round, and, with a hurried pace to one side, said, "What have I done? I have brought evil where it should not come. Let me go now, that more harm follow not."

staff,

"The old girl talks very freely to you, Travers, "said the chief of the "and seems to have confidence in you. Would you be so kind as to see that she gets a good dash* for her information, and that she is fed and housed somewhere handy. I may very likely want to see her again.

"Come, mother," I said, and led the way toward the Castle, where I intended to put her in the charge of the native police, who would be on duty somewhere near my quarters.

As we passed through the foul streets of the town, in which even the strenuous exertions of the medical staff could not succeed in enforcing the most ordinary sanitary regulations, I could not help remarking the sensation with which our progress was attended. The demeanor of the natives to a European officer was generally marked by listless curiosity, by a cringing subservience, the result of personal fear, or by an insolence acquired from the constant support of the negro against the white man, which was the outcome of recent local legislation under the influence of Exeter Hall humanitarianism. But to-day there could be no mistake about the genuine reverence with which I and my companion were treated, or, as I soon perceived, the awe which my companion inspired. We passed a group of natives recently embodied in Wood's

* West Coast expression for a present.

regiment, into whom a perspiring European officer was endeavoring to instil the first principles of military movements. There was an immediate pause in the drill, and the whole attention of the men was concentrated upon us, much to the disgust of the wearied instructor. The dull countenance of a West Indian sentry over some Government stores brightened into intelligence as he jumped to attention. Every Fanti woman with a basket of plantains on her head, and every lazy native porter making believe to bend under the lightest of loads, seemed to shrink and quail when they saw us, and to be prepared to prostrate themselves if we gave any sign of stopping. But I was in a hurry, as I had other duties to attend to, and we quickly arrived at the Castle. I had engaged a small fat Fanti boy as a servant, who, though as idle as it is in negro nature to be, and with very vague notions of the eighth commandment, was still better than the Sierra Leone servants, whom many special-service officers had imported to their sorrow, and supplied my simple requirements fairly well. As was to have been expected, he was enjoying a pleasant doze in a sunny corner, and woke with a start when I hailed him. "Here, Quacko! find the police sergeant, and say this old woman is to have lodgings and food given to her."

Quacko's usual brilliant black skin changed to a dull dingy green, and he seemed to hesitate whether he should obey my order or wait for further in- · structions from my old woman. She solved the problem, however, by saying, "I want nothing from the white man, though I am become his servant. Let me go my own way. I shall be found if I am wanted, and I shall never leave my friends altogether till Ashanti is no more. It is not good for me to remain in the white man's house, for sorrow comes where I am. I go to live near the market, where death is already. He is now my companion."

She was so decided that, as I had no authority to detain her, I was obliged to let her have her own way. She wrapped her cloth round her face and went toward the native market, where I knew that there were collected peoples of every African tribe, and which