making good any defects which may have arisen in his work, while the latter can never forget that he has Nature to reckon with whenever he makes mistakes. For the most part, Nature is a kind mistress, and displays a kindly disposition to surgeons. Nevertheless fickleness is one of her features, and occasionally surgeons are forcibly reminded of this inexorable fact by the havoc which is made of their work.

A man to be a good surgeon must be a good artist,' that is to say, he must be born with the instinct of his art. The knowledge and experience of his profession will never reach full fruition unless this be the case, nor can we expect the art of surgery to progress as an art without the aid of those who are instinctively surgeons. former days it was thought that no one could claim to be a good surgeon who was not a brilliant operator. But brilliancy in operating is now one of the last features which surgeons make any effort to cultivate. Obviously, in the interest of a patient, a brilliant operative display can be but of little value. An operation brilliantly performed is by no means the password to a successful result. To onlookers perhaps the display would excite admiration, and might even lead to the operator being congratulated, but the applause might nevertheless prove in the end to have been gained at the price of the patient's life. Thus with a view to his results a surgeon nowadays finds it most expedient to proceed deliberately with his work. No hurry, no effort to appeal to the admiration of spectators, no thought beyond the good of his patient, can be admissible in the practice of modern operative surgery. The reason for this is obvious-the ubiquitous microbe, ever ready to destroy the surgeon's best work, cannot lightly be disposed of, its evil presence is ever hovering around him while operating, and thus, of necessity, caution must be the watchword of the proceedings and brilliancy be supplanted by deliberateness. But the art of surgery must not be measured merely by its display in connection with operations. The mention of this matter recalls another fallacy with which the practice of surgery was formerly associated. The impression was at one time almost universal that a surgeon and an operation were convertible terms-that is to say, that a surgeon never lost an opportunity of operating, even regardless of the necessities of the case. However in former days the practice of surgeons may have justified this opinion, it is only true to say that no such reproach can now be urged against their successors. For, in truth, some of the best examples of modern surgical art are to be found among those cases in which the surgeon has deliberately refrained from operating, or has, in the place of a radical operation, performed one of a modified type with the utmost advantage to the patient. Some thirty or more years ago, the late Sir William Fergusson introduced the term 'conservative' surgery to professional

notice, and since then a new principle in the art has come to be established, making it imperative among surgeons to avoid as much as possible radical measures in all cases in which modified procedures give prospect of success.

Presumably it is quite unnecessary to point out that the terms conservative' and 'radical' as used in surgery are entirely without any political significance. In times, however, of general elections their use by lecturers on surgery are not usually allowed to pass without notice by the medical students. Perhaps I may be permitted to mention an instance in point. During the course of the General Election in 1874, when the banner unfurled by the then Mr. Disraeli was instrumental in gaining many seats for the Conservatives, an eloquent lecturer on surgery happened to have for his theme the treatment of diseases of the joints, during which he referred to the advances which had been made in the results by the introduction of the principle of conservative surgery. Doubtless he found himself unable to dissociate the term 'conservative' from the political events which were then absorbing the attention of the whole country, and it seemed, therefore, quite natural that he should describe the principle, reintroduced by Sir William Fergusson, as due to a 'conservative reaction.' But the mention of these two words had an electric effect upon his audience, for five minutes at least the walls of the sombre anatomical theatre resounded again and again with the cheers of the enthusiastic students. Utter amazement was depicted upon the mobile features of the lecturer at the tumult which he had thus unwittingly raised. He paused, made a vain effort to recommence his discourse, raised his hand deprecatingly, and at length began to show signs of displeasure. But all to no purpose; the students determined to have their cheer, and they had it. When silence was restored, he sagaciously remarked: 'Well, gentlemen, upon this occasion, I apprehend that you will not require me to discuss the question of the "radical" cure-a happy sally which was fully appreciated.

The great aim and ambition of the modern surgeon is to have good results, and no demonstration is needed to show of what paramount importance this ambition must be to his patients. Obviously the better are the results the greater must be the benefits derived by those upon whom his art is practised. In taking every effort to reduce the mortality from his operations, and to bring relief successfully to his patients, the modern surgeon has an infinitely more responsible and difficult task to perform than was the case with his confrères of an earlier age. A successful surgeon of the present time must in his way be a man of considerable scientific attainments-that is to say, his acquaintance with the collateral sciences of medicine and surgery must to a large extent be on a par with his knowledge of that special

branch of the profession to which most of his attention has been devoted. In the salutary competition, therefore, which exists for good results, humanity profits most. After all, by their fruits ye shall know them,' is an expression which is fairly applicable to surgeons and their work; a surgeon's results are to a tolerably trustworthy extent an index of his capacity and value.

HUGH PERCY DUNN.

THE ENGLISH LIBRO D'ORO

ONE of the most pathetic features in the present social revolution is the gradual passing away of our old landed families, around whose names associations cluster and historic memories are entwined. With every fresh edition of such a work as The Landed Gentry, the ranks of the Old Guard are slowly but surely thinned. How many ancient houses still survive among us? What are the names that have escaped the hungry waves of time? Such questions are sometimes asked: they are easier to ask than to answer. From the stately volumes issued by the late Ulster King of Arms, a reply will be sought in vain. Even if one were prepared to read them through for the purpose, their contents would be worthless for our purpose; they remain an unrivalled example of window dressing' applied to pedigrees. There does, however, exist a work which, though now little known, was intended to provide the information we seek. In Shirley's Noble and Gentle Men of England we have a record, not of the bearers of hereditary titles of honour, but of our ancienne noblesse in the true sense of the phrase. As such, it stands on a different footing from every other book dealing with family history.1

The lavish distribution of hereditary honours that modern times have witnessed has not only somewhat seriously lowered the prestige of peers and the status of baronets, but has tended to dissociate, in the popular mind, the idea of hereditary rank from that of ancient descent. Such an impression, though natural enough, is unjust, we shall find, so far as concerns the higher ranks of the peerage or baronetcies of early date; but it helps to accentuate the striking truth on which the late Professor Freeman was never weary of insisting, namely, that the fact of our possessing a peerage has actually prevented our possessing a true noblesse.

The growth of the peerage hindered the existence in England of any nobility in the continental sense of the word. . . . The noblesse of other countries in England remained gentlemen but not noblemen, simple commoners, that is, without legal advantage over their fellow-commoners who had no jus imaginum to boast of.

1 The Noble and Gentle Men of England, or Notes touching the Arms and Descents of the ancient Knightly and Gentle Houses of England, arranged in their respective Counties. Attempted by E. P. Shirley, M.P., F.S.A., 1859, 1860 and 1866.

There can be no doubt that the class in England which answers to the noblesse of other lands is the class that bears coat-armour, the gentry strictly so called. There is no real nobility in England, for the class which answers to foreign nobility has so long ceased to have any practical privileges that it has long ceased to be looked upon as a nobility, and the word nobility has been transferred to another class which . . . in strictness takes in only the peers personally.

The distinctive feature of Mr. Shirley's work was its disregard of titles, and its classification of our landowning houses according to antiquity alone. Hence it may fairly be described as the Libro d'Oro of England, the only record of our 'real nobility' in Mr. Freeman's sense of the word, a nobility resting on its own position, not created by the favour of the Crown. From that conception we have wandered further even in the one generation that has passed since his work appeared. Antiquity of descent has become of less, titles and orders of more account; in our age of hurry we have no time for the study of pedigrees or of coat armour; we prefer a 'nobility' ready labelled, and, recognising the change, for good or for evil, houses that might once have proudly declined to abandon the status of ancient squires for that of modern barons are now more willing to exchange their old lamps for new.

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The standard of the seize quartiers,' though still retained abroad, has always been alien to English ideas, and is, indeed, so little understood by us that it is sometimes supposed to imply sixteen quarterings. Purity rather than antiquity of descent is shown by this famous test, while it was with antiquity alone that Mr. Shirley was concerned. He confined himself, therefore, in the first place, to the families now existing, and regularly established either as knightly or gentle houses before the commencement of the sixteenth century,' by which test he wholly excluded 'the families who rose upon the ruins of the monastic system.' He further insisted on descent in the male line alone; and he claimed to exclude every family that had parted with its landed estate. Great were the heartburnings and jealousies caused by his work at the time; but these, he maintained, were due to misapprehension of scope and insufficient attention to the tests he had carefully explained. His own position as a country gentleman of old descent and ample estate enabled him to perform his task without fear or favour, and, when it was accomplished, to hold his ground in two subsequent editions.

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We do not say that Mr. Shirley's history is up to the latest standard; indeed, one has only to glance through his pages to see that, while eschewing, as he then believed, 'absurd pretensions of ancient lineage,' he accepted legends wholly exploded by the genealogical research of the last thirty years. The real drawback, however, for our purpose of his work is that he arranged it on the principle not of a 'tripos,' but of a pass list. All families that could satisfy his tests figure on an equal footing: families that date almost from the VOL. XXXV-No. 207 3 G