cases if the patient recovers the "assistant" gets no credit; if the patient dies he gets all the blame.

The hospital treatment of abdominal cases needs some elucidation. As a rule a general hospital is not an ideal place in which to open the abdomen, yet it is usually equipped with many conveniences that facilitate the work for the surgeon, and so he operates there often on that account. Private hospitals are less objectionable, and many such are without reproach in this regard. The technique of that management which is to-day conceded to be the best is little understood, speaking generally, by the physician in whose charge these cases have been previously; hence the great tendency to seek the shelter of either the public or private hospitals. Such being the case, it is well to take cognizance here of the fact that unjust strictures often arise from ignorant criticism of the management of individual cases in hospital, and a feeling occasionally is excited both against the hospital and the surgeons connected with it. This was lately illustrated in the trial of a prominent operator in the State of New York upon an indictment for manslaughter. A woman who had been operated upon at the defendant's private hospital desired to go home on the fourth or fifth day; her friends co-operated with her in the desire and actually did so remove her. She died of septic peritonitis soon afterward, hence the indictment and trial. It may be proper to add that a prominent newspaper, hitherto of reputable standing, lent its influ ence to accomplish the ruin of this surgeon, thus compromising the good name of legitimate journalism. The surgeon happily was vindicated by the Court and jury, but the lesson to be drawn from the case is that under no circumstances should a patient be removed from the place where the operation was done until convalescence or cure is established.

The factors, then, that enter into the inquiry, "What is the medico-legal status of the abdominal surgeon ?" and that largely determine that status, may be grouped and summarized follows:

as

1. The Operator's Ability.—What has been his apprenticeship, what his surgical aptitude, his experience, his fertility of resource -in short, speaking surgically, his abdominal instinct?

2. The Propriety of the Operation.-Has this been established beyond reasonable doubt, and have its necessity and dangers been fully explained to the patient and his or her friends; or, in case of minors, to guardians or parents?

3. The Consent of the Patient.-Has this been obtained in a

legal and binding manner, and have the near friends also consented; and in case of minors have the parents or guardians legally consented, and is there indubitable proof of this?

4. The Preparation of the Patient.-Has this been adequately done in accordance with the modern rules of abdominal surgery? 5. The Anesthetic.-What form of this was used, and was the anesthetizer experienced in the administration of anesthetics; were the proper precautions taken to determine the relative safety to the patient of the anesthetic chosen?

6. The Operation.-Has it been performed with that skill that the present light of the science would demand?

7. The After-Treatment.—Was this in all its details scrupulously and zealously carried out under the eye of the operator? Was a skilled nurse employed, who faithfully attended to her duties? Did the attending physician yield absolute control to the operator?

8. The Environment.-Was the operation done in hospital, public or private, or at the home of the patient?

9. The Transportation of the Patient.-Was the patient removed prior or subsequent to the operation? If so, under what circumstances? Was it with the advice and consent of the surgeon and under his superintendence?

On a trial for manslaughter resultant from a disastrous abdominal operation, some or all of these questions would form proper subjects for inquiry by the Court, and therefore appear germane to the purposes of this discussion. Doubtless others will be dealt with by the authors who jointly appear in this debate. I will, therefore, conclude what I have to say in a few brief sentences bearing on the rights of patients and operators:

A patient has the right to refuse operative treatment, however urgent or imperative the need.

After operation the patient has the right to refuse further attend. ance or treatment from a physician or surgeon who may have been in charge, either as operator or otherwise.

The patient, if sane, has the right to be removed at any time she may elect. Her actions or movements, her acceptance or nonacceptance of a course of treatment by her physician, are matters of her own option, over which he can exercise no legal control. She can go counter to or in accord with his advice, as she may will. He cannot exercise over her person any authority beyond that to which she consents.

For any act of duress the physician could be held legally liable.

In the matter of the husband, his legal control over the wife would not prevent her from submitting to surgical or other treatment at the hands of a physician of her own choice, but with her consent the husband would have the right to direct or control her movements in the face of any protest of the physician.

The same principles in a modified form apply in cases where there are guardians.

From the foregoing it will be seen that the physician is absolutely helpless in all cases that he cannot reach and control by moral suasion. This places the abdominal surgeon at a peculiarly trying disadvantage, for he is in the rather anomalous position of incurring grave legal responsibilites in cases where he has few legal rights or privileges.

284 Franklin Street, Buffalo, N. Y.

WILLIAM WARREN POTTER, M. D.

AN EDITORIAL VESPER HYMN.

THERE is a man in our town, and he is wondrous wise;
Whene'er he writes the printer man, he dotteth all his i's.

And when he's dotted all of them; with great sang froid and ease,
He punctuates each paragraph, and crosses all his t's.

Upon one side alone he writes, and never rolls his leaves;
And from the man of ink, a smile, and mark-"Insert" receives.

And when a question he doth ask (taught wisely he hath been), He doth the goodly two-cent stamp, for postage back, put in. -Artist Printer.

EASILY REPAIRED.-A widow whose husband had lost his life in a railway accident, received from the company 10,000 francs by way of compensation. Shortly afterward she heard that a traveler who had lost a leg on the same occasion had been paid 20,000 francs. The widow at once put on her bonnet and shawl, and trotted off to the offices of the company.

"Gentlemen, how is this?" she said. "Here you give 20,000 francs for. a leg, and you have only allowed me 10,000 for the loss of my husband!''

"Madame,” replied one of the clerks, "the reason is quite plain; 20,000 francs won't provide the poor man with a new leg, but a young lady with charms such as you possess can any day, for 10,000 francs, get another husband, perhaps a better one.”— Balt. Underwriter.

NEW YORK DEEDS.

THE NEW YORK Act to provide for short forms of deeds and mortgages. Chap. 475 of laws of 1890.

AN ACT to provide for short forms of deeds and mortgages. APPROVED by the Governor, June 2d, 1890. Passed, three-fifths being present.

The People of the State of New York, represented in Senate and Assembly, do enact as follows :

Section 1. In grants of freehold interests in real estate, the following or similar covenants shall be construed as follows:

(1.) A covenant that the grantor "is seized of the said premises (described) in fee simple, and has good right to convey the same," shall be construed as meaning that such grantor at the time of the execution and delivery of the conveyance is lawfully seized of a good, absolute, and indefeasible estate of inheritance in fee simple, of and in all and singular the premises thereby conveyed, with the tenements, hereditaments, and appurtenances thereto belonging, and has good right, full power, and lawful authority to grant and convey the same by the said conveyance.

(2.) A covenant that the grantee "shall quietly enjoy the said premises," shall be construed as meaning that such grantee, his heirs, successors, and assigns shall and may, at all times thereafter, peaceably and quietly have, hold, use, occupy, possess, and enjoy the said premises, and every part and parcel thereof, with the appurtenances, without any let, suit, trouble, molestation, eviction, or disturbance of the grantor, his heirs, successors, or assigns, or any person or persons lawfully claiming or to claim the same.

(3.) A covenant "that the said premises are free from incumbrances" shall be construed as meaning that such premises are free, clear, discharged, and unincumbered of and from all former and other gifts, grants, titles, charges, estates, judgments, taxes, assessments, liens, and incumbrances, of what nature or kind whatsoever.

(4.) A covenant that the grantor will "execute, or procure any further necessary assurance of the title to said premises'' shall be construed as meaning that the grantor and his heirs, or successors, and all and every person or persons whomsoever lawfully or equitably deriving any estate, right, title, or interest of, in, or to the premises conveyed by, from, under, or in trust for him or them, shall and will at any time or times, thereafter upon the reasonable request, and at the proper costs and charges in the law of the gran

tee, his heirs, successors, and assigns, make, do, and execute, or cause to be made, done, and executed, all and every such further and other lawful and reasonable acts, conveyances, and assurances in the law for the better and more effectually vesting and confirming the premises thereby granted, or so intended to be, in and to the grantee, his heirs, successors, and assigns forever, as by the grantee, his heirs, successors, or assigns, or his or their counsel learned in the law shall be reasonably advised or required.

(5.) A covenant that the grantor "will forever warrant the title" to the said premises shall be construed as meaning that the grantor and his heirs, or successors, the premises granted, and every part and parcel thereof, with the appurtenances, unto the grantee, his heirs, successors, and assigns, against the grantor and his heirs or successors, and against all and every person and persons whomsoever lawfully claiming or to claim the same shall and will warrant and forever defend.

(6.) A covenant that the grantor "has not done or suffered anything whereby the said premises have been incumbered in any way whatever," shall be construed as meaning that the grantor has not made, done, committed, executed, or suffered any act or acts, thing or things whatsoever, whereby, or by means whereof, the above mentioned and described premises, or any part or parcel thereof, now are, or at any time hereafter shall or may be impeached, charged or incumbered in any manner or way whatsoever.

Sec. 2. In any grant or mortgage of freehold interests in real estate, the words, " together with the appurtenances and all the estate and rights of the grantor in and to said premises," shall be construed as meaning, together with all and singular the tenements, hereditaments, and appurtenances thereunto belonging or in anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues, and profits thereof, and also all the estate, right, title, interest, dower and right of dower, curtesy and right of curtesy, property, possession, claim, and demand whatsoever, both in law and in equity, of the said grantor of, in and to the said granted premises, and every part and parcel thereof, with the appurtenances.

Sec. 3. In any deed by an executor of, or trustee under a will, the words, "together with the appurtenances, and also all the estate which the said testator had at the time of his decease in said premises, and also the estate therein which said grantor has or has power to convey or dispose of, whether individually or by virtue of said will or otherwise," shall be construed as meaning, together