sible moment,
and could deal with them practically first hand. Every day I
realized more strongly the advantages of such a hospital, and
the importance for the wounded of the first surgical treatment
they receive. Upon this may well depend the whole future
course of the case. No wounded man should be sent on a long
railway journey to the base until he has passed through the
hands of a skilled surgeon, and has been got into such a
condition that the journey does not involve undue risk. And no
rough routine treatment will suffice. A surgeon is required who
can deal with desperate emergencies and pull impossible cases
out of the fire--a young man who does not believe in the
impossible, and who can adapt himself to conditions of work
that would make an older man shudder, and a man who will
never believe what he is told until he has seen it for himself. For
the conditions of work at the front are utterly different from those
of civil practice, and it is impossible for any man after many
years of regular routine to adapt himself to such changed
environment. The long experience of the older man will be of far
more use at the base, and he will have plenty of difficulties to
contend with there.

I have often been told that there is no opening for skilled
surgery at the front. In my opinion there is room for the highest
skill that the profession can produce. It is absurd to say that the
abdominal cases should be left to die or to recover as best they
can, that one dare not touch a fractured femur because it is
septic. To take up such an attitude is simply to admit that these
cases are beyond the scope of present surgery. In a sense,
perhaps, they are, but that is all the more reason why the scope
of surgery should be enlarged, and not that these cases should
be left outside its pale. I am far from advising indiscriminate
operating. There are many things in surgery besides scalpels.
But I do urge the need for hospitals close to the front, with every
modern equipment, and with surgeons of resource and energy.

But for a surgeon this war between nations is only an incident in
the war to which he has devoted his life--the war against
disease. It is a curious reflection that whilst in the present war
the base hospital has been given, if anything, an undue
importance, in the other war it has been practically neglected.
Our great hospitals are almost entirely field hospitals, planted
right in the middle of the battle, and there we