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the operations in at least two, perhaps in three, if I had screwed my courage up to a still harder strain, and I blame myself accordingly."

Mr. Tait in his work on "Diseases of the Ovaries,"* says: "Whenever, in an exploratory incision, the bladder is found pulled up and spread over the front of the tumor for a considerable distance, the proceeding may at once be brought to a conclusion, for it may be regarded as perfectly certain that the tumor cannot be removed."

Olshausent says: "At the present time it may be claimed that adhesions never make the operation impossible. But when the connection of the tumor with adjacent organs, especially the rectum, is unusually firm, and when the papillary formations of the tumor have grown into the wall of the organs, complete extirpation will be impossible. How rare this is in reality is shown by Schroeder's dictum that nearly every ovarian tumor may be extirpated. Tumors which he could not remove two years ago, he now extirpated completely in a second laparotomy."

Kaltenbach says: "And despite all our progress in technique, cases remain in which the operation cannot be completed, because the connections of the tumor with surrounding parts are too firm and extensive, or are imperfectly defined. In cystic tumors we may confine ourselves to partial extirpation, and stitch the pelvic segment of the tumor into the lower angle of the wound."

Fritsch says: "Should the adhesions in the lesser pelvis be firm, it would be exceedingly dangerous to loosen them. Shroeder obtained the best results by cutting off the upper part of the cyst and sewing the rest into the abdominal wound. The sac, thus separated from the peritoneum, rapidly diminishes." My friend, Dr. Howard A. Kelly, of Philadelphia, who passed through the city this morning, tells me that he never yet encountered an ovarian cyst which he could not remove.

On the other hand, Dr. Skene Keith, in his second series of fifty ovariotomies had two incomplete operations, with one death. Dr. John Homans, in 290 ovariotomies stitched the cyst to the skin in eight cases; *The Pathology and Treatment of Diseases of the Ovaries. New York: Wm. Wood & Co.

†Diseases of the Ovaries. By R. Olshausen. New York: Wm. Wood & Co. A Handbook of General and Operative Gynecology. By Dr. A. Hegar and Dr. R. Kaltenbach. New York: Wm. Wood & Co.

?The Diseases of Women. By Heinrich Fritsch. New York: Wm. Wood & Co.

all recovered. Mr. H. C. Cameron, in twenty-eight cases had two incomplete operations, with one death. Terrier, in twenty-five cases recently reported, had five incomplete operations, with two deaths. It is evident from these quotations and statements, that incomplete operations occasionally happen in the practice of the best operators, but as their experience grows, such cases get less frequent, even to the point of disappearance; but when they do happen the mortality approximates fifty per cent.

My own impression is, that if a cyst, firmly and extensively adherent to intestines, bladder and pelvic floor, is encountered by an operator who has not a most extensive experience and extraordinary skill, and if he feels that persistence in attempts at removal will result in the rupture of intestines, bladder, or iliac vessels, his patient is much safer with the incomplete operation.

THE postal laws makes it larceny to take a newspaper and refuse to pay for it. A newspaper in Illinois recently brought suit against 43 men who would not pay their subscriptions, and obtained judgment in each for the full amount of the claim. Of these 28 men made affidavit that they owned no more property than the law allowed them, thus preventing attachments. Then they, under decision of the Supreme Court, were arrested for petty larceny, and bound over in the sum of $300 each. All but six gave bond, while six went to jail.-Pharm. Record.

CLAIRVOYANCE AND MALPRACTICE. -The Supreme Court of Wisconsin has rendered a very important decision, says the New Haven News, that a clairvoyant physician is liable for failure to exercise the ordinary skill and knowledge of a physician in good standing, practicing in the vicinity, and not merely to the ordinary skill and knowledge of clairvoyants. It is held by the Court that if any one holds himself out as a medical expert and accepts employment as a healer of diseases, but relies for diagnosis and remedies upon some occult influence exerted upon him, or some mental intuition received by him when in an abnormal condition, he takes the risk of the quality of accuracy of such influence or intuition.— Boston Med. and Surg. Journal.

PARKE, DAVIS & Co.'s SUIT against Dundas, Dick & Co., for infringing their patent in making empty capsules, has recently been decided in favor of the plaintiffs, and an injunction and an accounting having been entered against Dundas, Dick & Co.

MEDICINE.

BY WILLIAM WARNER, M. D., CIRCLEVILLE, OHIO.

Ever since the time of Hippocrates and Aristotle, the pioneers of medicine, the bewailing and sorrowful cry of suffering humanity has been audible everywhere. Each science and profession that has been struggling in its developments throughout the ages, has been signally characterized by the many false and erroneous impressions and views that ever retarded and delayed its progress. Two hundred years since, astronomy, physics, geology, etc., had assumed considerable order, and their principles established correctly are accepted unto this day. A legal chair was created at the Cambridge University, England, in 1756, where a system of legal principles was taught, which at the present constitutes the reading matter for every beginner in the study of law, being a century and a quarter old. Principles of human experience true then are no less so to-day; in this particular, being essentially different from the profession of medicine. As late as the seventeenth century medicine was one chaotic mass of tradition, empiricism, witchcraft, etc.; for the practice of the latter, many honorable, innocent people were unceremoniously killed. The medical literature of an hundred years ago is useful only to supply the interests of history.

Not only was the laity ignorant in regard to the principles of physiology and medicine, but the actual members of the profession were most fearfully and dangerously ignorant in their medicinal administrations. The extent of ignorance, at present, of the general public, is a serious and fatal weapon in the hands of empirics and audacious pretenders. No member of the profession of law can, by prating and ostensible pretension, convince a court, a jury, or even the public, that he possesses the wisdom of ages, and is amply competent to discharge all the duties that may devolve upon him properly and efficiently. Incompetency and inability in this profession can be successfully detected and easily averted. No one can claim great artistic acquisitions in performance on musical instruments without his false pretensions being manifest on the first demonstration. One pretending to possess a knowledge of the various languages, would certainly meet with little success in the practical proofs of his claims, etc.

I can not now recall an occupation, a business, or a profession, in

which ignorant pretenders can so succesfully and advantageously practice their nefarious claims as in the profession of medicine. The laity, being absolutely and hopelessly void of all information pertaining to this subject, are irretrievably compelled to submit to the erroneous, injurious and fatal practices these infamous ghouls and vampires so ignominiously impose; for what layman distinguishes them from the most enlightened savant of the profession? They thus receive all the honor, the tribute and compensation of the most erudite. The majority of human ills, as they promiscuously occur, will kindly submit to nature's bidding without any interference from cheap diploma carriers, who are entitled to the right of being just as ignorant as they please, and yet legally empowered with the privilege of exercising their dangerous and evil practices, legally protected by their diplomas, the significance of which, after the coveted parchment is secured, is found in abandonment of all further study, all medical literature being relegated to oblivion. In prescribing, an old, repeated, beaten track is soon established. A library is found consisting of a few old volumes, dating back to '50 or '60, and these nearly obscured from view by accumulated dust. Time not occupied at the practice is spent in loitering about stores, hotels and other public places where idlers congregate to exchange ideas on base ball and other gossip of the day. Here the M. D. is almost invariably found, especially if there happens to be a session on, for which he keeps out an eye. Here he maneuvers for an opportunity to detail to his anxious hearers the particulars of a case or two he so scientifically conducted. He never fails to have on hands a number of instances in which he secured compli⚫ cated cases from other physicians, pronounced incurable, and through his superior acquisitions and skill restored to perfect and permanent health. Every falsehood of his is accepted in confidence by the people as true, thus creating favorable impressions in his behalf. He is sure to take especial precaution to give valid reasons why certain cases of his resulted exactly the reverse of his prognosis, relieving himself of all responsibility of error by explaining away mistakes, to the utter satisfaction of interested friends. Perhaps he simultaneously charges a neighbor physician with malfeasance in order to effect personal exoneration. And so he most lamentably and hopelessly continues his nefarious and atrocious impositions on an ignorant, credulous and helpless public, which surely deserves pity for its inability to discern the right.

By way of illustration and corroboration of the truth of my statements, I will relate the essential features of a few instances that have

come under my observation and experience during a period of ten years' practice in the profession of medicine. Some of these may, from their odious, disgraceful and contemptuous character, appear wholly incredible, but the truthfulness of every word would cheerfully be attested by an oath before a notary. Each case I shall refer to is connected with a doctor holding a diploma from a medical college.

The chief features of the first case occurred but a few days since. A young man came into my office for the purpose of consulting me professionally. A casual glance at this patient led me to suspect he was suffering from some serious lung disease. He had a sallow, clouded skin, great emaciation, rapid breathing, frequent and feeble pulse, pain in the right side, inability to expand the chest over an inch on forcible inspiration, great pain on excessive respiration; percussion elicited dullness, changing to flatness over the inferior part of right lung. Auscultation showed a limited extent of tubular breathing about the apex. Not a sign of vesicular respiration could be detected anywhere over the middle and inferior part of the lung. Night sweats profuse, loss of appetite, occasional vomiting and extrusion of mucus, pus and other matters; cough with moderate expectoration, etc. Scarcely was there a sign or symptom wanting characterizing lung disease. I told this patient that his entire trouble was in the right side of his chest; that his right lung was almost entirely useless; that very little air circulated through it, and that at the apex. The patient seemed very much surprised at my view of the case, for he had consulted another physician giving a different conclusion. He desired to know if I could cure him, I replied: "I can give you no encouragement whatever. If you desire me to treat you I'll do so to the best of my ability, but I shall make you no encouraging promises. You might possibly improve some, but in case you do not, I will not have disappointed you." He quite reluctantly stated his desire that I treat him for a period anyway. This I did, prescribing C. L. O. and the general supportive treatment usually adopted in this class of cases. The patient left my office apparently much discouraged. He returned in a few days, but with no particular change other than an aggravation of his general condition, being so greatly emaciated that he was exceedingly weak. The spinous processes of his vertebral column were very prominent and sore. He discontinued his visits to me after the second call, the first and last prescriptions being made respectively on the 6th and 15th of May. I subsequently learned the patient's friends advised him to consult another physician, since I had virtually acknowledged I could

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