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 Civil Malpractice in the Middle Ages.

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LAWS GOVERNING CIVIL MALPRACTICE IN THE MIDDLE AGES.' BY CHARLES GREENE CUMSTON, M. D. THE question of civil malpractice is of in terest to both the medical and legal professions, and of recent years many rather unusual cases, involving medical liability have been tried in various courts of the United States. That the physician and sur geon have been held liable for their actions by the courts of justice is as old as law, and it occurred to the writer that publishing * few scattered notes he had made on the his tory of this subject might not be without in terest, although he must concede lhat the question consigned in the following pages is only superficially discussed. Among the Egyptians the law punished very fully any too imprudent or audacious physician, and in the seventh volume of his Histoire de la Legislation, de Pastoret savs that "General rules had been established for the treatment of patients. These were the result of carefully-made observations which were guarded by the priests in books that were so respected that they were solemnly carried in the processions taking place on days of public fete. An absolute prohibition did not exist preventing the physician from applying a new truth, but if far from obtain ing the salutary effects that he expected to procure he caused the death of his patient, he was obliged to pay his tribute for the mis fortune or the boldness of having sacrificed the life of a citizen, by being beheaded. On the other hand, he was never liable to a pa tient confided to his care when he followed the rules laid down in the Sacred Books." The same authority says that the Greeks also admitted medical liability, and Tourdes quotes an example related by Plutarch of a certain physician of Ephesus, by name Glaucus, who, having left his patient to go to the 1 Read by invitation at the Annual Meeting of the Massachusetts Medico-Legal Society, June 9, 1903.

theatre, was condemned by Alexander to be put to the cross because the patient, having imprudently eaten during his absence, died. In Roman law the principle of medical lia bility was admitted, and this is proof positive since it is so formally stated in the old texts. This can easily be understood since at Rome anyone could practise medicine who so wished, and generally speaking, the slaves practised the healing art, which was a source of large income for their masters. These physicians, or perhaps it were better said empirical practitioners, had no other end than the gain of money, and there was, con sequently, a double motive for making them liable for mistakes committed in the exercise of their practice. On the one hand, there was no guarantee offered by a diploma at testing to serious studies and a certain science, while on the other, there was a com plete lack of devotion and scientific disinter estedness. A physician who gave his services to a patient was responsible to the master, if the latter were a slave, and he fell under the juris diction of a suit Icge Aqiiilia or under the ap plication of suit for the hire of labor. The first clause of the law Aquilia covered in point of fact those cases where another's slave had been killed without right. It was quite sufficient that a slave had been mor tally wounded. The physician who, after having operated upon a slave, abandoned the after-care and allowed him to die was at fault according to the terms of the law which ran as follows: "Praterca si medicus qtii servitm tuum sccuit, dereliquerit curationem, atque ob id mart-nits fuerit serviis, cidpae reus est." (Instit. Liv. IV., tit. III., Section VI.) There was also error on the part of a phy sician who by ignorance killed his patient