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These cases are by no means rare or infrequent cases in which there is constant and intolerable pain day and night, and where the strain of seeing the suffering is agonizing to the bystanders. Now in these cases is the surgeon to blame if, urged on to do it by the patient, urged on by the patient's friends, yea, urged on by his own humanity, he attempt some heroic operation which inwardly he knows has no chance of success, but which he also knows will in all probability relieve the patient not only of his sufferings but of life itself, and in which in fact the surgeon acts the part of the friendly executioner? That question it is not for me to answer.

something is done, may offer as a last hope some remedial treatment by operation. Each of these classes requires different consideration. Το take first the cases where an operation is performed in order to clear up obscurity. These are often so-called exploratory operations; these in my opinion should never be performed until every other method of perfecting the diagnosis has been exhausted. The surgeon or physician should train his hand and mind so accurately as to be able to determine what is going on inside by external examination which involves no risk; he should exercise patience, and if necessary ask for further advice, if he doubt his own competence, in preference to submitting his patient to risks which may prove fatal, and which in many cases are quite useless. In those cases that are likely to prove fatal unless some operative procedure is adopted, the possibility that he may be wrong in his diagnosis should be considered, and the question whether he is not deluding himself in saying that there is a chance, and so embittering the last moments of his patient, and adding to the already grievous trouble and anxiety the friends are suffering from without any firm hope of giving relief; in fine, he ought to let nature have a chance, that nature which often performs what seems almost the notice and investigation of miraculous. The most difficult problem to face is the one mentioned, where a case is admittedly hopeless but where the patient is suffering from such intolerable and unrelievable agony that it is felt that something must be done if possible; where not only is the patient himself suffering, but all his relatives and friends are tired out, and even where a staff of trained nurses is unequal to the task; the last resources of medicine and surgery are required to cope with these miserable and unfortunate cases.

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Sufficient has now been said to answer my purpose, i.e. to found a basis on which to establish my thesis that the present position of operating surgery has founded what is in fact a new tribunal, and one, moreover, of great and far-reaching power with very little, if any, responsibility, and that in the interests of the people at large it is quite time this far-reaching power and lack of responsibility should be seriously inquired into, and that if it is found necessary its powers should be limited and its responsibility vastly increased by bringing each individual case operated upon, at any rate where a fatal termination ensues, under

an authorized court of inquiry, either a new court of inquiry to be established for the purpose or some modification of the present Coroner's Court. In all other cases of death by violence or misadventure there is an inquiry made to determine if anybody be at fault, and there is no reason why in this particular instance such an inquiry should be evaded. As before stated, if a merchant captain or a naval captain lose his ship or have it seriously damaged either with or without loss of life, or if a military officer lose a posi

tion, stores or men, an inquiry or courtmartial is at once instituted and the officer in charge has to clear himself of incompetence, ignorance, or want of due care in the discharge of his duties, and there is invariably an inquest on a person who dies under chloroform or any other anæsthetic. If so, there can be no reason why the operating surgeon in case of dire failure and loss of human life should not also be called upon to vindicate his conduct and capacity. If he were thus liable to be called upon he would be stimulated The Independent Review.

by a grave sense of responsibility not to enter upon or undertake any such operation in a flippant, uncertain manner, knowing that if he did so he would be required to furnish unimpeachable and incontrovertible reasons for having so undertaken it, and subjected his patients to perils of such consideration and moment as to involve the possible loss of their life.

James A. Rigby, M.D. (Consulting Physician to the Preston and County of Lancaster Victoria Royal Infirmary.)

AMELIA AND THE DOCTOR.

CHAPTER VII.

ANTAGONISM OF THE MAN OF RELIGION

And the MAN OF SCIENCE.

The antagonism, or at least the supposed antagonism, of religion and sci.ence was personified for us in Barton by the Vicar and the doctor, and though all of us were greatly grieved, it is not likely that any of us were vastly surprised to hear that a disagreement, deserving to be called by some stronger name than a discussion or even a dispute, had occurred be.tween them on the occasion of a morning call paid by the Vicar at the doctor's house. None of us, I fancy, ever made out exactly what was the begin.ning of the dispute that indeed, where there were so many points of differing opinion, scarcely repaid the trouble of conjecture-but every one of us had heard, repeated again and again, the shocking conclusion, that Dr. Charlton actually had taken the Vicar-in his youth a University athlete, who even now could have destroyed peppery little Dr. Charlton with a single fisticuff:the doctor actually had taken him by the collar of his clerical coat, and

kicked him, not in any metaphorical, but in the brutal, physical sense, had kicked him out of the house. Molly, the doctor's maid, had overheard high words, and peeping out affrighted from the door, held ajar, of the passage leading to the kitchen, had witnessed the act of sacrilege. The Vicar, with a true Christian spirit, said nothing whatever of the occurrence, but the news was soon told abroad by Molly communicating it to Miss Carey's Phoebe, and other gossips in the village. So soon as the doctor had thus shockingly ejected the Vicar from the house and slammed the door behind his visitor, Molly watched him ascending the stairs again, apparently in a mood of penitence, muttering sadly to himself, as he went, "No improvement! No improvement!" a phrase that he was known to use very frequently, after one of his many outbursts of temper.

Naturally enough our conversations and comments on this extraordinary and distressing occurrence were very many. A large number of us formed ourselves, without confessing as much, even to ourselves, into a kind of amateur detectives, watching for a meeting

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between the doctor and the Vicar in the hope of seeing how the late antagonists would comport themselves. our spying, however, had only this negative result-that the two plainly avoided a meeting. There was a moment when they were seen almost to rush into one another's arms as one went up and another down the village street, but the doctor skilfully avoided an absolute collision by diving into the village sweet-shop. It was known that he then and there purchased a pennyworth of bull's-eyesstrong evidence of his perturbation of mind, for he had a dislike of peppermint in all forms that was notorious. While all of us of course were much shocked by this unwarrantable attack on a clergyman, whose cloth at least should have kept his person sacred, there was one above all to whom it was a cause of genuine distress. This was poor Miss Carey, who questioned all her friends many times a day about the possibility and the means of reconciling the parties to this apparently wholly one-sided feud, for the Vicar, debarred alike by his Christian profession and his Christian spirit, had taken only a very passive part in it. It was to him, first, that Miss Carey addressed herself in her character of peacemaker. The Vicar expressed himself exceedingly willing to forget and forgive the offence, but insisted-and most justifiably, as Miss Carey was very ready to admit-that the first advance must be on the part of the wrongdoer. It would detract, so the Vicar urged, from his position as a Christian gentleman and his dignity as a minister of the Gospel, if he, who had been treated with such gross disrespect, were to be the first to sue for a renewal of the old relations between himself and the doctor. If the doctor would show but a sign of advancing the olive branch, he, on his part, readily would go more than half way to receive it, but the advance

must come in the first instance from the other side.

Miss Carey rightly felt that this attitude was the utmost that she could expect or ask of the Vicar, who had been subjected to such indignity. In her own quietly composed way she addressed herself to the far more difficult task of inducing the doctor to hold out the hand of penitence for the wrong that he had done.

"Madam," said Dr. Charlton, when she began to reason with him, "if the man attacked me only, I would say nothing" (possibly, so little do we know ourselves, it was the doctor's sincere belief that in saying this he spoke the truth, both in the bold affirmation that he would have kept silence and also in the subtle implication that he had been the victim of the first attack). "If he impugned my own position only, I should know then how to defend myself. But it is when the fellow puts up a man of straw in my place and imputes to me arguments which I should not dream for a moment of advancing, it is then, madam, that, I have to confess, I do somewhat lose my patience with him. I, he informs me, believe in annihilation at death. I never told him that I believe such a thing. I do not believe it; but neither do I deny it: I preserve a state of suspended judgment. Further, he proceeds-arguing (or what he is pleased to call arguing) on these false premises -to tell me that with such a hypothesis as this for the final end I have taken away from man every possible reason for looking on the gift of life as a thing to be grateful for. Just consider the folly of the man, my dear Amelia. To say that we have no reason to be grateful for this life, just because we can foresee nothing but annihilation after it! It is a perfect absurdity, and practically a contradiction in terms. It is as much as to say that life loses its happiness just because of

the conception of a time to come when there shall be no life. If no life, and the loss of life, can be a thing so sad that the very thought of it as a future possibility can throw a shadow over us years before its arrival, then life itself must indeed be a very positive joy. The fact that we hate to die is but a form of statement of the fact that we love to live. Life certainly has a balance of pleasures over pains, and therefore we love it, and therefore too we should be grateful for life even if the conviction is forced upon us (I do not say it is) that annihilation is to be the end of it. The right name for a man who refuses gratitude to the Creator for the gift of life is not materialist, it is fool, no matter what his view may be of his probable ultimate fate. If the pains of life were greater than the pleasures, then indeed we should be justified in not being grateful for it, but in that case we should not dislike the prospect of annihilation, we should welcome it as a surcease of pains. That-such a folly as that—as much as to say that a child cannot love a piece of toffy because it can conceive a time when the toffy will be all sucked away-was really at the root of our little trouble. Then the man was kind enough to inform me that the twopence extra for manners had not been charged at my school (no doubt quite true), and I replied that the twopence for logic had not been charged at his (which certainly was no less true), and then I believe I may have said things that perhaps I ought to be sorry for. I am not sure: I really forget what I said. Most of us do say things we ought to be sorry for. I believe we all do, except you, Amelia; and I, I know, say them more often than most people. But I do not think that I really am sorry for them, Amelia. No," he started up from his chair and began to stamp up and down the room, positively snorting with indignation. "No, 1770

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LIVING AGE.

VOL. XXXIV.

I am quite sure I am not sorry for them. The fellow deserved every word of them; and if he was here now-I only wish he was-I would take the opportunity of saying every one of them over to him again-that is to say," he added, as if by an afterthought, "if I could not think of something worse."

This did not seem a very promising mood of a man in which to persuade him to an apology, but Miss Carey had a lifelong knowledge of the doctor, and she did not allow herself to despair. For the moment she turned the conversation aside to the topic of some of the sick people in the village, and probably with some quite unconscious subtlety referred to cases which had the effect of touching the very tender heart that Dr. Charlton, as we all knew, carried under such a very truculent covering, so that as he rose to take his leave he was in a far more malleable temper than one who did not know him intimately could have conceived possible for a man who had spoken with so much heat a little while before. And then, as Miss Carey said good-bye to him, she made an appeal in a personal way that must have been very difficult for him to resist.

"It has distressed me so much, Richard," she said, "this little disagreement of yours-I may say, this very shocking disagreement-with the dear Vicar." Dr. Charlton began to sniff, in a way that was very characteristic of him when embarrassed. "You will do your best to make it up again, Richard, I know," Miss Carey pursued, possibly affecting a greater confidence than she felt. "It would be so very sad if the two leading men in Barton were to continue at serious difference. To oblige me, Richard, you will do your best to reconcile this disagreement, will you not?" And whether it was the tone of Miss Carey's words, the gentle touch of her hand, laid in aid of her pleading on his arm, or the very real

look of trouble in her face-whatever the influence was, it proved of sufficient strength to impel the doctor to blow his nose most fiercely on a crimson pocket-handkerchief, as though by this means he would expel the germs of evil feeling and malice from his system, and to say with emphasis, "Yes, to oblige you, Amelia, I will do this. There is very little you could ask me that I would not do-to oblige you. But the fellow is a fool, madam," he concluded, with a sudden change of tone "a blatant fool."

"You could not expect to find him gifted with your scientific attainments, you know, Richard," Miss Carey said, with a gentle flattery that perhaps did not miss its mark, notwithstanding

that it caused the doctor to blurt out"Scientific attainments! Scientific humbug! All that I ventured to ask of him was a little common sense. I shall know better than to expect such a thing of him in future. But I will do what I can. I will do my best."

There is no doubt that the good doctor was quite genuine in his protestations that he would do his best, but it must be admitted that it would be likely to prove a very uncongenial task indeed for a man of his temperament to go to another and confess himself in the wrong. Carey had gained her point so far as this, then we were again on the watch with a new interest-to see the manner in which the doctor would make confession of his error, and ask forgiveness. Probably, we concluded, he would seek a private interview with the person whom he had wronged, but even if that should be so we were very hopeful that by some means we would be informed of it. The manner in which, finally, the reconciliation was effected was one that we could not by any possibility have foreseen. was as striking as it was touching; and its telling involves the narration

When we heard that Miss

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of an episode in the history of the village that eventually proved to be of the very greatest importance in its bearing on the lives of several of the actors in this little drama.

CHAPTER VIII.

ONE OF MRS. COPMAN'S LODGERS RE

CONCILES THEM.

I think I have said, or, at all events, I am quite sure I have implied, that Mrs. Copman's cottage in the village was large enough to enable her to take in lodgers. In the summer she often had one or more boarders of the lower middle or even of a humbler class. Her lodgers invariably appeared quite contented, condoning, it is to be supposed, the sharpness of their hostess's tongue, which she did not take the slightest pains to restrain in their favor, for the sake of the comfort, as she and they understood it, which she succeeded in giving them at a very moderate cost. This being the case, we were by no means surprised at the appearance in the village of two persons, strangers to us, seeming to be to each other in the mutual relationship of father and daughter, nor to learn that they were boarders in the spare rooms of Mrs. Copman's premises. The father was a little man of wizened and rather repellent face, which was redeemed by its look of intensely eager vivacity. His figure was small and wizened like his face, but all his movements were made with a bird-like quickness and agility that seemed only in keeping with the alert and restless inquiry of his eye. The girl was very white-faced and delicate-looking. Indeed both father and daughter had unmistakably the appearance of town-bred people, contrasting rather pathetically with the apple-cheeked healthiness of our country villagers. It was understood that they had been brought down from

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