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November 1920


Arch Surg. 1920;1(3):585-602. doi:10.1001/archsurg.1920.01110030180010

One of the important problems confronting the conscientious surgeon is that of gaining access to deep seated pathologic conditions in such a manner that the patient may suffer the least possible postoperative anatomic damage. It is true that our first duty is to save or prolong life, and to cure disease. But if in our efforts to accomplish these laudable things we leave the patient with a new pathologic condition of an equal or even more disabling character than the disease itself, then the surgical treatment was ill-advised or ill-managed, and the cause of surgery will suffer because of the fact that the patient continues to suffer.

A number of lesions amenable to surgical treatment are amenable only through the infliction of serious and permanent anatomic damage. This is often the case in the surgery of cancer and in various infections which threaten the patient's life or limb. In such