handicapped. In this age, when we have so frequently to deal with the so-called border-line cases, it is especially well never to cease being a physician.
"We would next have the young man assure himself that he is the possessor of a well-developed, healthy, working 'surgical conscience.' No matter how well qualified he may be, his enthusiasm in the earlier years of his work will lead him to do operations that he would refrain from in later life. This will be especially true of malignant disease. He knows that early and thorough radical measures alone hold out hope, and only by repeated unsuccessful efforts will he learn to temper his ambition by the judgment that comes of experience. Pirogoff, the noted surgeon, suffered from a malignant growth. Billroth refused to operate or advise operation. In writing to another surgeon friend he said: 'I am not the bold operator whom you knew years ago in Zurich. Before deciding on the necessity of an operation, I always propose to myself this question: Would you permit such an operation as you intend performing on your patient to be done on yourself? Years and experience bring in their train a certain degree of hesitancy.' This, coming from one who in his day was the most brilliant operator in the world, should be remembered by every surgeon, young and old."
Oh, surgery! Modern aseptic surgery! In the hands of the skilled, conscientious surgeon how great are thy powers for good to suffering humanity! In the hands of shysters "what crimes are committed in thy name!"
With his own school full of shysters and incompetents, and grafters of "new schools" and "systems" to compete with on every hand, the conscientious phy-
[75]
