772 THE POPULAR SCIENCE MONTHLY. 



removing more than lie did of the amputated limb. Such a verdict is 

 tantamount to saying that the physician ought to have known better 

 what course to pursue, and was therefore guilty of ignorance, on which 

 ground it would, perhaps, have been better to base the verdict than 

 on an error of judgment. 



Fortunately for the profession, there are some limitations upon its 

 liability. Ordinarily the physician is supposed to possess a famil- 

 iarity with the characteristics of the dominant disease. As it has been 

 summed up : " His diligence and care will be exercised in watching 

 for and guarding against the numerous accidental influences which, if 

 overlooked, may delay or even prevent the restoration of the patient, 

 such as latent predisposition to certain diseases ; a lack of vital or re- 

 cuperative power in the patient ; the effects of melancholy and of 

 other passions of the mind ; the effect of the want of pure air and 

 good food ; of careful attendance and nursing ; the neglect of the 

 patient to follow the physician's advice, or to take the medicines which 

 he prescribes." 



A surgeon once, in a case of dislocation of the elbow-joint, replaced 

 the bones and put the arm on a pillow ; with the part below the joint at 

 a right angle with that above it, and directed the application of cold 

 water, but omitted to give warning that the arm must remain in 

 that position. Assuming for the moment that such treatment was 

 enough, the Court declared such omission to be culpable negligence 

 on his part. Had he, however, performed his task skillfully, omit- 

 ting nothing, and then the patient had neglected to comply with his 

 directions, the surgeon's liability would have been limited. For in 

 the case of the sane it is the patient's duty to cooperate with the phy- 

 sician or surgeon, and conform to necessary prescriptions. If he will 

 not, or under pain can not, his negligence is his wrong or misfortune, 

 for which his physician is not responsible.* 



If the patient's neglect to obey the reasonable instructions of his 

 medical attendant, contributes to the injury complained of in an ac- 

 tion for malpractice, he can not recover. f Contributory negligence is 

 a good defense, and in this respect the patient is " on all-fours " with 

 the man who is run over while walking on a railroad-track without au- 

 thority. Neither can recover. While there may have been negligence 

 on the part of the engineer or the doctor, yet, the pedestrian and the 

 patient being equally at fault, no recovery can be had. But, if the 

 patient has neglected to use necessary precautions, because lulled into 

 a sense of security by the doctor, the doctor will be liable. A refusal, 

 however, on the part of the patient, to prevent an attempt to remedy 

 the injury already caused by malpractice, does not necessarily preclude 

 a recovery, if the refusal was made without reasonable assurance that 

 the attempt would be successful.^ And it would seem that refusal, 



* 22 Pennsylvania Statutes, 2G1, 1 Phil., 138. 



t 25 Ohio Statutes, 86. % 68 Pennsylvania Statutes, 168. 



