Crude craftsmen.

THIS MORNING, ladies and gentlemen, I have the honour and pleasure of addressing you on behalf of the consultant medical staff of this great hospital. A task approached with some diffidence for unlike so many of my illustrious predecessors I am neither orator, historian, scientist or philosopher, but simply one of a long line of crude craftsmen the title of my address who have endeavoured since time immemorial to relieve suffering humanity by cutting and in particular cutting for stone. Advance in any branch of medicine is related to contemporary progress in every branch of science and its strength lies in the number and vigour of its allies. Modern operative techniques are more successful than in the past, not due so much to improved surgical skill, but to advances in the para-surgical subjects. On 8th May, 1967, I carried out an operation that had never been intentionally performed previously in this hospital, that of nephrectomy, knowing that the kidney to be removed was the only one the patient possessed. Prior to operation I knew through the help of my colleagues in the hospital laboratories and X-ray departments, the nature of the disease process affecting the kidney and how that disease was affecting renal function and the patient's health. I not only knew the position, size and shape of the kidney but had before me in the operating theatre beautifully clear pictures of all its blood vessels large and small. With the best anaesthesia in the world available the operation under such circumstances was a simple anatomical exercise and so I could assure my patient, a woman of 37 years, beforehand that there was no danger to her life. Also I could tell her that life could be adequately maintained post operatively by renal dialysis and later renal transplantation. Like so many of the life saving measures now employed by the medical profession, transplantation of the kidney has taken its place in the therapeutic armament only after a stormy passage. For many years the utilisation and so the development of blood transfusion was declared illegal and prohibited by all the influential professional bodies in Europe. The Faculte de Medicine and the Royal Society opposed its use. Rome condemned it as completely inexcusable. The introduction of anaesthesia was similarly condemned by many of the medical profession as a dangerous experiment and by divines as a violation of the law of God. Renal transplantation, in spite of opposition from medical and laymen, church and state is now generally accepted as a definitive line of treatment and can I hope be left in the capable hands of those medical men and women specially trained in that science and art, remembering that our profession has continued to work for centuries under a code of conduct formulated long before the Mother of Parliaments was established.