Manual of the principles and practice of operative surgery / by Stephen Smith.

  • Stephen Smith
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Manual of the principles and practice of operative surgery / by Stephen Smith. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    18/710 (page 4)
    judfinent and manual dexterity are essential elements in the prac- tice of operative surgery. Though both are important, they are not equally so; good judgment in the selection and employment of remedial measures excels manual skill in effecting favorable residts in cases where both are required.^ When ha])pily combined in the same person they give the highest measure of success. But as these quali- ties are susceptible of unlimited improvement by culture, the sur- geon is culpable who does not attain to that degree of skill which the civil obligation exacts. IV. RESPONSIBILITY. The civil obligation imposes important individual responsibilities upon the surgeon. He must exercise his best skill and judgment in every case.'^ And wherever great and extraordinary skill is pos- sessed, causing his employment exclusively on that account, he must bestow it to the full measure of his ability, since the exceptional de- gree of that skill is the moving consideration to his employment.^ The responsibility also for the success of every operation which he performs is individual. He may decline to undertake any case,^ but having accepted the trust, he alone is responsible for the re- sults of treatment.'* Neither the attending physician, nor the con- sulting surgeon, assumes any portion of the obligation. Through- out the entire case the conduct of the surgeon must be character- ized by fidelity to the patient, and a uniform and consistent appli- cation of skill in the treatment of the disease. Failure at any time to meet the ordinary indications in the case vitiates the entire at- tendance, for the obligation is continuous to the termination.^ In view of these facts, it is important that the surgeon should make every case which he undertakes peculiarly bis own. He should fore- cast every possible source of failure, and be prepared for every possi- ble emergency, for he is the most ready to take responsibilities and to bear them lightly who can best estimate what are the risks and difficulties which he is to incur.^ In diao-nosis, prognosis, operation, and after treatment, his opinions should be formed, and his course of procedure marked out and followed, without being unduly influ- enced by the solicitation of patient or friends, or the sugirestions of consultants. Every step should be taken with that painstaking care and deliberation which leaves no ground for a charge of ignorance, negligence, or want of skill. Thus the surgeon not only fulfills the just requirements of the obligation, civil and professional, but se- cures that confidence and self-reliance in every stage of progress and in ever)^ emergency so necessary when great responsibilities are as- sumed. 1 J. Ashurst, Jr. '■' Paten v. Wigjiin. ^ j. Ordronaux : .J. J. Evvell. * F. C. Skey. 5 Bellinger v. Craigue. 6 Sir J. Paget.