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                     REPORT
                       ON
                    SURGERY
                     TO THE
               SANTA CLARA COUNTY
                MEDICAL SOCIETY.

                       BY
             J. BRADFORD COX, M. D.

             _READ MARCH 2d, 1880._

                   SAN JOSE:
              MERCURY STEAM PRINT.
                     1880.




REPORT ON SURGERY.


In presenting this report I will not attempt to give any historical data
connected with the subject of surgery, since that has been ably done in
the 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 her
laws; or, more properly speaking, God and His laws.

When we say that oxygen and iron unite and form ferric oxide, we express a
law of matter: that is, that these elements have an _affinity_ for each
other. A collection of similar facts and their systematic arrangement, we
call chemistry. Or we might say, chemistry is the science or knowledge of
the elementary substances and their laws of combination.

When we say that about one-eighth of the entire weight of the human body
is a fluid, and is continually in motion within certain channels called
blood vessels, we express a law of life, or a vital process. When we say
this fluid is composed of certain anatomical elements, as the plasma, red
corpuscles, leucocytes and granules, we go a step further in the problem
of vitality. When we say that certain nutritious principles are taken into
this circulating fluid by means of digestion and absorption, and that by
assimilation they are converted into the various tissues of the body, we
think we have solved the problem, and know just the essence of life
itself. But what makes the blood hold these nutritious principles in
solution until the very instant they come in contact with the tissue they
are designed to renovate, and then, as it were, precipitate them as new
tissue? You say they are in chemical solution, and the substance of
contact acts as a re-agent, and thus the deposit of new tissue is only in
accordance with the laws of chemistry. Perhaps this is so. Let us see as
to the proofs. In the analysis of the blood plasma, we find chlorides of
sodium, potassium and ammonium, carbonates of potassa, soda, lime and
magnesia, phosphates of lime, magnesia, potassa, and probably iron; also
basic phosphates and neutral phosphates of soda, and sulphates of potassa
and soda. Now in the analysis of those tissues composed principally of
inorganic substances or compounds, it will be seen that these same salts
are found in the tissues themselves.

So also the organic compounds lactate of soda, lactate of lime, pneumate
of soda, margarate of soda, stearate of soda, butyrate