xxx INTRODUCTION
pressure he could reproduce the unconsciousness which had preceded the evacuation of the pus. The patient made an excellent recovery.
Hartley's method for removal of the Gasserian ganglion has already been mentioned and soon found most general use. Americans have performed nearly half the entire number of Gasserian ganglion operations thus far reported.
A complete tabulation of all cases of brain tumor operated upon up to 1903 shows (article by Keen and Tinker in Chipaults "L'Etat Actuel de la Chirurgie Nerveuse," vol. iii), that nearly one-third of something over three hundred brain tumors then reported had been operated upon by American surgeons with a proportionately large number of successful cases.
The surgery of the respiratory and circulatory system belongs for the most part to strictly modern surgery, since the discovery of anesthesia and antisepsis. One operation by an American surgeon in the pre-anti- septic days deserves mention, however. Operation for gangrene of the lung is still a matter of decided gravity. While there may be some doubt as to the cause of extensive disorganization of a large part of the right lung reported by Anthony ("Philadelphia Journal of the Medical and Physical Sciences," 1823, vol. vi), gangrene seems the most likely cause, and his operation, involving extensive resection of the fifth and sixth ribs, is certainly noteworthy. A hasty search through the "Surgeon- General's Catalogue" does not show any record of such an operation antedating Anthony.
Gross's important monograph on "Foreign Bodies in the Air Passages" has already been mentioned, as also Fowler's operation of decortication of the lung for old empyema. At the present time, with a better educated body of general practitioners, the occasion for extensive operations for the relief of permanently collapsed lung following long standing accumu- lation of pus is less frequent and none of these operations are frequently called for. If such an operation is needed, the fact that Fowler's opera- tion permits re-expansion and use of the crippled lung seems to make it preferable to the operation of Schede or Estlander, which, while they permit recovery of the patient, do not restore the use of the crippled lung.
Intubation as a substitute for tracheotomy is now in general use. Very likely it would be considered a medical operation, although it supplants an important surgical procedure. Certain it is that O'Dwyer, who introduced intubation, was a physician and not a surgeon. While the results after tracheotomy for obstruction of the larynx by membrane in diphtheria were usually fatal, intubation has given a large percentage of recoveries. As Matas ("Annals of Surgery," 1S99, vol. xxix) strikingly puts it: "His (O'Dwyer) medical transformation of the
