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taking the heart out of the oncometer ments. Thus, so long as the funcand handling it very gently) produced fibrillation and death. Neither the blood pressure nor the volume changes of the heart form a safe guide with the alkaline solution. The injection of salvarsan seems to bring out any inherent cardiac weakness, and the contention of Ehrlich and others that myocarditis should be regarded as a contra-indication for its intravenous
tional capacity of the heart is unknown, there will always be danger of sudden cardiac failure. A heart may be able to meet all ordinary requirements, and may seem normal, and yet these ordinary requirements may demand all that the heart is able to give; when an extraordinary occasion arises such a heart is unable to respond, and is forced into fibrillation and diastolic
use finds support thru Auer's experi- stoppage.
In opening a Department in a medical journal for the elucidation of questions affecting the relationship of the physician and surgeon to the law, it is well to have clearly understood at the outset the obligation which the doctor assumes toward his patient, and, as well, the duties taken up by the patient when he accepts the services of the physician or surgeon. For we shall have to bear this relationship clearly in our minds thruout the series of discussions that will appear in this Department, else we shall fail to profit by them.
This relationship is based entirely upon the legal significance of contracts, and perhaps a few words on this subject will clear the air and allow a broader discussion as to the effect of this law of contracts on the physician or surgeon and on his patient.
I. In the offer of an act for a promise.
2. In the offer of a promise for an
3. In the offer of a promise for a ing to his best judgment. promise.
The doctor is affected by the first where the act is the giving of services on his part in return for the promise of the patient to fulfil certain duties on his part, as for instance the payment for those services when completed.
5. That he will not leave a patient without the consent of the patient or relatives unless he gives reasonable notice or furnishes the services of another physician.
6. That he will not experiment on his patient but will always consider the welfare of that patient exclusively.
7. That he will not disclose any communication received from the patient or discovered in his examinations during the course of treatment.
The patient on his part contracts: I. That he will give the physician all information concerning the facts and circumstances of his case and full opportunity to treat him properly.
That he will obey his instructions and follow his directions.
3. That he will pay the doctor the reasonable worth and value of his services.
All of the different elements enter
The practitioner, then, implies, when ing into the contract have been litihe undertakes a case: gated and from time to time cases will be cited in these columns and explained and their bearings on the practitioner gone into. An endeavor will be made to steer the physician and surgeon clear of the legal difficulties that lie in his path and to show him where he may enforce his rights.
Now this offer and acceptance may be either expressed or implied. They are expressed when a definite arrangement is made either in writing or orally in the presence usually of witnesses. An express contract is entered into when a physician or surgeon undertakes to treat a patient for a certain time or for a certain disease and the patient agrees to pay a certain, definite sum for such services.
Usually the contract is implied and no special time for treatment is specified or amount of payment definitely named.
3. That he will exercise reasonable care in the management and treatment of the case.
4. That he will always act accord
I. That he is reasonably educated in his profession, taking into account the locality in which he practices.
2. That he possesses a reasonable degree of skill and will exercise it, i. e., such skill as a competent medical man ordinarily possesses and exercises.
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