a sharp knife and a clean pair of hands surgical debates on the role of laparotomy, 1880 to 1900：一把锋利的刀和一双干净的手外科手术的辩论，剖腹手术的作用，1880至1900.pdfVIP

“A Sharp Knife and a Clean Pair of Hands:” Surgical Debates on the Role of Laparotomy, 1880 to 1900 Robert E Bulander Jr, MD Nicholas Senn, speaking before assembled delegates of Etheridge,2 of Rush Medical College, told the Chicago the American Medical Association’s (AMA) 1886 an- Medico-Legal Society in 1890, and “there is nothing nual meeting, triumphantly proclaimed that “surgery settled concerning the method of performing abdominal has gained the supremacy over medicine.” He justified surgery.” The propriety of exploratory laparotomy be- his statement by noting that the “improved technique” came an especially fierce point of debate in the 1880s of surgeons since Lister’s introduction of antisepsis had and 1890s. Proponents of a more aggressive role for furnished “almost absolute protection against wound in- operation in the management of abdominal disease ar- fective diseases,” making “the legitimate sphere of the gued that “a clean pair of hands allow of almost any- physician” smaller and allowing the surgeon to treat “in- thing” in the abdomen3; more conservative surgeons juries and lesions beyond the reach of medical agents.” 1 protested that one could not just “open and explore the Senn’s address gives the impression that surgeons, hav- recesses of the complex structure of the peritoneum, ing at last cast aside the albatross of wound sepsis, were with as much impunity as one would raise the lid of a wholeheartedly charging forward into a golden age of chest” without killing one’s patients.4 This article will serve as a brief review of some of the “safe” surgery. But were Senn’s contemporaries actually ready to do majo