cedure is fully established by the experience of numerous gynæcologists. Bird has reported forty instances of such openings without a single death, and Atlee two hundred and fifty cases with a similar result. Again, there are errors of diagnosis which arise from visual defects. There are two ways in which the eye may prove unreliable: first, from an inability to appreciate the symmetrical harmony of parts, and secondly, from a defect of the retina, in consequence of which the person is incapable of properly distinguishing the colors of natural objects. With regard to the first, I do not propose to discuss the geometrical theory of the beautiful-which, as Hay supposed, consisted in a specific combination of arcs of varying degrees-but only to hint at that incapacity which fails to recognize the binary correspondence which belongs to corresponding portions of the body, or to discover slight deviations from the natural or artistic configurations of the human form. From this cause incipient spinal curvatures, obliquities of the pelvis, alterations in the contour of joints, and tumors in the bony cavities of the face are frequently overlooked. With reference to the second defect, that which ophthalmologists term "color blind," it is doubtless the source of many errors on questions involving the particular tint or hue of objects. Usually the trouble is with red and green, and when it exists, would render its possessor incompetent to judge correctly on one of the most common phenomena of inflammatory disease outside of our own profession. It is more than probable that some of the terrible railroad accidents which now and then send a wail of grief over the land, may find an explanation in this optical imperfection, rendering the engineer unable to distinguish between the red and the green signal lights which gleam out in the darkness of the night as he drives his engine along our iron roads. There are also phenomena connected with the refracting media of the eye, which, would my time permit, might be shown to exercise no small influence in perverting professional judgment. The evil consequences resulting from a slight neglect may also be seen in our omission to uncover the parts which are to be the subject of examination. In this way luxations of the humerus are often undetected because the physician has made his investigation without removing the clothing from the shoulder. Thrice have I known persons to perish from strangulated hernia who had been treated for colic, the medical attendant having been blinded by the representations of the patient to the effect that no swelling existed in the neighborhood of the hernial passages. A large number of errors of diagnosis may be placed to the account of ignorance. Take an example. A young woman raised in indolence and luxury, leading an aimless life of fashionable dissipation, and cultivating only the emotional part of her being, by pouring over the light, trashy literature of the day, is suddenly confined to her bed with the most alarming symptoms of joint disease. Pain is no expression for the articular distress; it is agony: the sound of a foot-step, or the rustling of a curtain becomes intolerable. Sympathizing friends gather around the bed; obsequious servants consume the hours of the day in bearing cards, messages of inquiry, and boquets of fragrant flowers to the sufferer's room, and worse than all the doctor comes, and then follow blisters, purgatives, sorbefacients, splints, and finally the hot iron. Month follows month, and still there is no abatement of the disease. Yet here is a joint, without preternatural heat, without redness, and without swelling. A joint, the exterior of which is in a state of extreme hyperæsthesia, the nutrition of the limb unchanged, and at no time has there been a trace of constitutional or febrile disturbance. And so the poor girl is left to linger along with her unreal infirmity, until some sagacious man is called in, who sees through and through the hysteroidal sham, and tells her to rise up and walk. These are the cases which have brought so much odium on the profession, and which have invested the shrewd charlatan, into whose hands they so often fall, with the semblance of miraculous power. In disease of the spinal column, how frequently do we see extensive displacements of the vertebræ developed before the medical attendant awakens to a full consciousness of the fact, and this notwithstanding the little sufferer has for months been walking in a stiff mechanical manner, with shuffling feet and fixed elevated shoulders, sometimes leaning over chairs, or resting, in the midst of childish sports, with the hands upon the knees, seeking for that support, which the weary and enfeebled muscles of the back refuse to give. Nor is it less common to meet with children, the subjects of coxalgia, who have long been treated for rheumatic disease, when the transparent skin, the enlarged lymphatic glands, a flattened buttock, the obliteration of the gluteo-femoral groove with pain at the knee, and elevation of the pelvis on extreme flexion of the thigh, all betokening the true nature of the malady. Frequently do we encounter instances of undetected luxations of the humerus, although the flattened shoulder, the prominence of the acromion, and the projecting elbow, signs which indicate the character of the accident, are so patent that he who runs may read. Under the same head, viz., ihat of ignorance, must be placed those cases in which hernia, varicocele, and hydrocele are confounded with one another, and frequently subjected to unskilful treatment, or that very common mistake of treating anal fissure for hemorrhoids. Errors of diagnosis not unfrequently originate perplexing litigations. Many of the suits instituted against surgeons for malpractice arise in this way. In the case of Hare against Professor John J. Reese, before Judge Thayer, the plaintiff claimed damages on account of a slight shortening of the limb, following an injury to the hip, and which had been pronounced by another medical man to have been due to an undetected and badly-treated fracture of the thigh. The shortening, which amounted to about three-fourths of an inch, and which had been progressive, and which had made its appearance several months after the injury, there were strong reasons to believe was attributable to an insterstitial absorption of the neck of the femur. In like manner, the malicious suit brought against Professor Gross, by the friends of a negro man, was based on an erroneous opinion expressed by a surgeon, who was incompetent to judge in the premises, and who, moreover, was himself a notorious fomentor of discord. In a recent suit of Weaver against Strickland, before Judge Junkin, at New Bloomfield, in this State, damages were claimed by the plaintiff on the ground that the doctor, as was stated by a medical gentleman who subsequently visited the lady, had mistaken a fracture in the upper third for one situated at the lower third of the femur. The evidence in this case clearly showed that the fracture had been oblique, and that the trifling prominence discovered four inches below the great trochanter was in reality the upper end of the lower fragment. In almost every suit for malpractice, with which I am acquainted, singular as it may appear, there has been a doctor at the root of it. I do not wish to be understood as advocating a policy which would shield any member of our profession from the just consequences of ignorance, recklessness, or neglect, but I do say, that any medical man who ventures to assail the professional skill, or to lessen the confidence of the public in a brother practitioner, without being conversant with all the facts in dispute, and having the most conclusive evidence of the correctness of his own diagnosis, deserves, in the highest degree, public censure, and should be ostracized by the entire body of medical men. Prosecutions of this kind are becoming entirely too common. No man, whatever be his position, or however eminent in his profession, but may be subjected to the most vexatious suit and oppressive damages from the merest insinuation of a jealous rival, or from the malice of a thriftless vagabond, who has no higher motives to gratify than to avoid the liquidation of professional services, or the extortion of black mail. Why such a spirit should manifest itself, either on the part of physicians or laymen, is to me one of the insoluble problems of the century. Having thus indicated in a very imperfect manner the most common sources of error in the detection of disease, let me say that there will always remain a considerable number of cases, the nature of which no amount of experience, skill, or caution can fathom. There comes a time in the professional life of every medical man when he finds himself hemmed in by impassable limitations, beyond which he cannot go. Hannibal could conquer the Alps and the Pyrenees, but not the Apennines; and there comes also an hour when the physician will make a mistake. If not, his experience will have been very unlike my experience. An error may be a source of mortification, but it is certainly, in many instances, not a thing to cover a man with dishonor and shame. I believe that one mistake to a wise physician is more instructive than twenty successes. To err is human, and when we consider the obscure and subtle nature of the problems with which medical men have to contend, the wonder is not that mistakes are occasionally committed, but the rather, that they are not more common than we find them to be. There are some persons who never commit errors, or committing them, never have the magnanimity to acknowledge that they were deceived. I confess that I am humbled every year in this respect. Like Lucretius I sink the lead over and over again and find no bottom. Indeed I know I shall never attain to such an imperial reach of wisdom that disease will surrender all its secrets at my bidding. I shall make mistakes as long as I am in the flesh. There never was but one physician who knew all the truth, and He was divine. With what tenderness does nature conceal her unsightly deformities by the interlacing tendrils of ivy or of rhus, which she so ingeniously spreads over the smitten tree or the rugged cliff. Emulating her example, let us, over each other's imperfections, draw, with loving hand, the veil of Charity. TREASURER'S REPORT. Benjamin Lee, Treasurer, in account with the Medical Society of the State of Pennsylvania. 66 14. June 14. To balance of former account "cash received from Schuylkill Co. Med. Soc., for extra copies 66 Transactions of 1876 Mercer Co. Med. Soc., balance of account Juniata Co. Med. Soc., for dues of 1877 $913 34 9 00 600 6 00 15 00 22 50 16 50 18 00 150 00 49 50 12 00 66 6. 66 66 66 Washington Co. Med. Soc., dues of 1877 Butler Co. Med. Soc., for dues of 1877 42.00 12.00 330 00 28 50 37 50 66 19 19 Mercer Co. Med. Soc., for dues of 1877, 66 46 66 on account Northampton Co. Med. Soc., for dues of 1877, on account Clarion Co. Med. Soc., for dues of 1877 30 00 13.50 28 50 1 50 54 00 66 66 :: Schuylkill Co. Med. Soc., for dues of 1877 60 00 66 46 66 46 46 66 66 Snyder Co. Med. Soc, for dues of 1877 15 00 33 00 24 00 16 70 46 Lehigh Co. Med. Soc., for dues of 1877 21.00 19 50 34 50 30 00 66 00 |