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ON
TO THE
BY
READ MARCH 2d, 1880.
SAN JOSE:
MERCURY STEAM PRINT.
1880.
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In presenting this report I will not attempt to give any historical dataconnected with the subject of surgery, since that has been ably done inthe report of last year.
I shall assume, and that without hesitation, that surgery is a science,properly so-called. That it is an art, is also true. But what is science?What is art? Science is knowledge. Art the application of that knowledge.To be more explicit, science is the knowledge we possess of nature and herlaws; or, more properly speaking, God and His laws.
When we say that oxygen and iron unite and form ferric oxide, we express alaw of matter: that is, that these elements have an affinity for eachother. A collection of similar facts and their systematic arrangement, wecall chemistry. Or we might say, chemistry is the science or knowledge ofthe elementary substances and their laws of combination.
When we say that about one-eighth of the entire weight of the human bodyis a fluid, and is continually in motion within certain channels calledblood vessels, we express a law of life, or a vital process. When we saythis fluid is composed of certain anatomical elements, as the plasma, redcorpuscles, leucocytes and granules, we go a step further in the problemof vitality. When we say that certain nutritious principles are taken intothis circulating fluid by means of digestion and absorption, and that byassimilation they are converted into the various tissues of the body, wethink we have solved the problem, and know just the essence of lifeitself. But what makes the blood hold these nutritious principles insolution until the very instant they come in contact with the tissue theyare[Pg 4] designed to renovate, and then, as it were, precipitate them as newtissue? You say they are in chemical solution, and the substance ofcontact acts as a re-agent, and thus the deposit of new tissue is only inaccordance with the laws of chemistry. Perhaps this is so. Let us see asto the proofs. In the analysis of the blood plasma, we find chlorides ofsodium, potassium and ammonium, carbonates of potassa, soda, lime andmagnesia, phosphates of lime, magnesia, potassa, and probably iron; alsobasic phosphates and neutral phosphates of soda, and sulphates of potassaand soda. Now in the analysis of those tissues composed principally ofinorganic substances or compounds, it will be seen that these same saltsare found in the tissues themselves.
So also the organic compounds lactate of soda, lactate of lime, pneumateof soda, margarate of soda, stearate of soda, butyrate of soda, oleine,margarine, stearine, lecethine, glucose, inosite, plasmine, serine,peptones, etc., are found alike in the tissues and in the blood plasma.That they are in solution in the plasma is well known,—that they are ina solid or precipitated form in the tissues is also true,—and that thetissues are supplied from the blood is also evident,—because the blood isthe only part that receives supplies of material direct from the foodtaken and digested.
That carbonate of lime and phosphate of lime are precipitated orassimilated from the plasma to form bone, is admitted by allphysiologists. That the carbonates and phosphates already deposited