ÆäÀÌÁö À̹ÌÁö
PDF
ePub

totaled $312.81. The jury evidently fixed the sum of $1,000 for pain and suffering. We are satisfied from the facts in the case that this sum was a reasonable compensation for her injury. At any rate, it was not excessive.

was sufficient under the statute in either | Her expenses, physicians' and hospital bills case. We are of the opinion, therefore, that the complaint was sufficient upon this point. [4] It is next argued that it does not appear from the complaint that Tony John was acting within his authority as a deputy sheriff when he shot the respondent. The complaint alleges, at paragraph VIII, as follows:

"That, on the 25th day of May, 1915, while acting within the scope of his authority as said deputy, and armed as aforesaid, and while attempting to apprehend, arrest and secure said Trotto, and believing the plaintiff herein to be said Trotto, but without taking any means or precautions whatever to satisfy himself of such fact, the defendant Tony John did, without provocation, * wrongfully, heedlessly and feloniously shoot at said plaintiff through the closed door of her room with said revolver, believing said shot was necessary to secure the body of the said Trotto.

It is plainly alleged here that the act was done by Tony John while acting within the scope of his authority as such deputy sheriff. In the case of Johnson v. Williams, 111 Ky. 289, 63 S. W. 759, 54 L. R. A. 220, 98 Am. St. Rep. 416, a Kentucky case, where two deputies were sent out by a sheriff to arrest the person charged with felony, and where they discovered two men in a buggy, one of whom they believed to be the guilty person, and their command to stop was not obeyed, one of the deputies shot, killing one Williams, who was in the buggy. The sheriff in that case was held liable, because the deputy acted under color of his office.

So in this case the complaint alleges, and the evidence clearly shows, that at the time Tony John fired the shot through the door he believed the occupant of the room was the person he was looking for. He fired the shot in an attempt to perform his duty as an officer. He was acting as such officer, and fired the shot because he was instructed by the sheriff to bring the prisoner in dead. There can be no doubt that he acted under color of

his office, and the complaint and the facts in the case are sufficient to show that he was acting within the scope of his authority as a deputy sheriff. Greenius v. American Surety Co., 92 Wash. 401, 159 Pac. 384.

Several instructions were excepted to, and are briefly argued by the appellants, but they raise the same questions which are disposed of in what is said above. There was no error in the instructions.

We find no error in the record. The judgment appealed from is affirmed.

ELLIS, C. J., and FULLERTON, PARKER, and HOLCOMB, JJ., concur.

(96 Wash. 182)

DISHMAN v. NORTHERN PAC. BENEFI-
CIAL ASS'N et al. (No. 13813.)
(Supreme Court of Washington. May 8, 1917.)
PHYSICIANS AND SURGEONS 18(8)-DEGREE
OF SKILL-NEGLIGENCE-LIABILITY.

In a malpractice suit for alleged negligence in treating an injury to plaintiff's wrist, where doctors of equal skill and learning, being in no way impeached or discredited, disagreed as to the proper manner of treatment for the injury as alleged by plaintiff and advisability of an operation not performed by defendant, plaintiff cannot recover, because of failure of proof of negligence, since an award of damages would rest upon mere speculation and conjecture.

[Ed. Note. For other cases, see Physicians and Surgeons, Cent. Dig. § 43.]

Department 2. Appeal from Superior Court, King County; Boyd J. Tallman, Judge.

Action by Ora P. Dishman against the Northern Pacific Beneficial Association, the Northern Pacific Railway Company, and A. w. Z. Thompson. Judgment of dismissal was entered as to the corporate defendants. From a judgment for plaintiff against the defendant Thompson, he appeals, and plaintiff cross-appeals from the judgment dismissing

the defendant Northern Pacific Beneficial Association. Judgment against Thompson reversed, with direction to the superior court to dismiss the case, and judgment of dismissal as to the Beneficial Association, from which plaintiff has cross-appealed, affirmed.

Griffin & Griffin, of Seattle, for appellant. C. H. Winders, of Seattle, for respondents.

PARKER, J. The plaintiff, Ora P. Dishman, commenced this action in the superior court for King county seeking recovery of damages from the Northern Pacific Railway Company, the Northern Pacific Beneficial Association and Dr. A. W. Z. Thompson, one of the surgeons of the Beneficial Associa

[5] It is lastly argued that the verdict is excessive. The record shows that the bullet which struck the respondent passed through the fleshy part of the hip near the pelvic bone. In order to remove the bullet, which tion. The damages sought to be recovered necessitated an operation, a cut, 3 or 4 are for alleged personal injuries suffered by inches long, and 21⁄2 inches deep, was made Dishman as the result of malpractice and upon her hip. Numerous small nerves were negligence on the part of Dr. Thompson in injured. She was in the hospital for 18 days, failing to properly treat the injured extensor on crutches thereafter for a week, and was tendons of Dishman's left hand and wrist. unable for more than 9 weeks to follow her The Railway Company and the Beneficial Asoccupation, which was that of a waitress. sociation were made defendants, and sought Her condition thereafter was very nervous. to be held liable to Dishman upon the theory

For other cases see same topic and KEY-NUMBER in all Key-Numbered Digests and Indexes

that Dr. Thompson was acting as their agent, tion at Auburn, soon after the accident occurin the treatment of Dishman in pursuance red. Dr. Hoye immobilized the wrist and of the duty which it is claimed they each hand with splints and bandages, and upon owed to him, resulting from monthly pay-examination of it a day or two later sent ments to the Beneficial Association from his Dishman to the hospital of the association wages as an employé of the Railway Com- at Tacoma for treatment. Upon arriving pany, entitling him to medical and surgical at the hospital on December 28th Dishman treatment as occasion might require. The was placed in charge of Dr. Thompson, who case proceeded to trial before the court sit- was one of the hospital surgeons, for treatting with a jury, when at the close of the ment. Dr. Thompson then removed the handevidence introduced in Dishman's behalf a ages, and took an X-ray photograph of the motion was made in behalf of each of the wrist and hand, and again immobilized the three defendants challenging the sufficien- injured parts. Dishman did not stay at the cy of the evidence to support any recovery hospital for treatment, but went to his home as against either of them. This motion was at Auburn of his own accord, being entitled granted by the trial court as to the Rail- to remain at the hospital for treatment if he way Company and the Beneficial Association, so desired, but choosing to go to his home and judgment of dismissal entered according- and be treated as an outside patient, returnly, and denied as to the defendant Dr. ing to the hospital from time to time for Thompson. The trial thereupon proceeded treatment. He went to the hospital several as against Dr. Thompson, and at the close of times for treatment up until February 25th, the evidence introduced in Dishman's be- two months following the accident. During half counsel for Dr. Thompson again chal- these visits Dr. Thompson re-dressed the inlenged the sufficiency of the evidence to sup-jury several times and took additional X-ray port any judgment as against him, and mov- photographs of the wrist and hand, giving ed that the court so decide as a matter of Dishman liniment, with directions for its law and enter judgment accordingly. This use. motion was by the court denied, the case was submitted to the jury, and a verdict rendered awarding damages in Dishman's favor and against Dr. Thompson. The suffiDishman, becoming dissatisfied with the ciency of the evidence was again challenged treatment received, did not go back to the by counsel for Dr. Thompson by motion time- hospital after February 25th, but went to ly made for judgment notwithstanding the Dr. Silliman, at Seattle, who thereafter had verdict, which motion was by the court de- charge of the case. On January 25th, evinied, and judgment thereafter rendered in dently for the first time, it was discovered accordance with the verdict. Dr. Thompson that one or two of the carpal bones were has appealed from this judgment, claiming broken. This was dimly shown by the X-ray he is entitled to judgment absolving him photographs, but was apparently overlooked from liability as a matter of law, or in any up to that time. No portion of the outer event that he is entitled to a new trial. flesh or skin of the wrist or hand was broDishman has cross-appealed from the judg-ken, or became broken, at any time during ment of dismissal as to the Beneficial Association, claiming that the court erred in its judgment of dismissal as to the Beneficial Association, and that he is entitled to a new trial as against it. No appeal is taken from the judgment of dismissal as to the railway | arm, and it was with some difficulty that he

company.

Dr. Hoye redressed the injury at Auburn two or three times during these two months, though he was not the physician having charge of the case.

the two months' treatment by Dr. Thompson. The result of the injury was such that Dishman, while under Dr. Thompson's care, could not raise his hand or extend it backward beyond the projected line of the fore

could extend it even in a straight line with On December 25, 1914, while in the employ his forearm. This weakened condition of of the Railway Company as a brakeman, the hand and wrist, it is contended in DishDishman was severely injured. He was man's behalf, was caused by the rupture and standing on the stirrup of a freight car, hold- severance of the extensor tendons, being ing to one of the grabirons above, his wrist those tendons on the back of the hand and resting on the iron, and his left hand down wrist which enable one to open and extend between it and the side of the car, when his the hand backward, even beyond the projectfoot slipped off the stirrup, resulting in the ed line of the forearm, when the wrist and weight of his body forcing his wrist down hand are in a normal healthy condition. As upon the iron, injuring the carpal bones of we proceed, it will appear that the several his wrist and the tendons on the back of surgeons who testified upon the trial do not his wrist and hand. The severity of the in-agree in their opinions as to the extensor jury evidently resulted from the fact that tendons being severed. his hand was held between the grabiron and the side of the car, so that his wrist was forced down upon the iron as a lever upon a fulcrum. The injury was first treated by

The alleged negligence in the treating of Dishman's hand and wrist during the two months following the accident, upon which Dishman rests his right to recover damages,

"That when the plaintiff arrived at said hos- This court has recognized the law to be pital for surgical treatment the defendants that a physician is not an insurer of a cure wrongfully, carelessly, and negligently failed, neglected, and refused to perform any surgical in cases of affliction under his care for treatoperation upon plaintiff's left wrist to bring the ment, and that he is not to be held liable as ends of the broken tendons together, and wrong- for negligence or malpractice for mere failure fully, carelessly, and negligently failed, neg; to cure, or for bad results because of his lected, and refused to perform any surgical operation upon plaintiff's left wrist, to suture choosing one of two or more methods of or in any manner to fasten the ends of the bro- treatment, when such choosing is an exercise ken tendons together, and wrongfully, careless- of honest judgment on his part, and the ly, and negligently failed to do anything what- method so chosen is one recognized by the soever to afford the plaintiff any relief whatsoever from the condition he was then in, but medical profession as a proper method in the wrongfully, carelessly, and negligently allowed particular case, though it might not meet the the plaintiff's left wrist and extensor tendons unanimous approval of the medical profesthereof to remain without any treatment of any kind whatsoever, and that thereafter for two sion. We shall presently review some of the months, during all of which said time the de- authorities supporting and illustrating this fendants had complete control of the plaintiff doctrine, which we here notice in general and complete control of the care and treatment terms only, as preliminary to a review of the of the plaintiff's left wrist, the defendants did not, nor did either or any of them ever, do any- testimony of the physicians given upon the thing whatsoever to benefit the plaintiff's left trial touching the question of the negligence wrist or tendons thereof, excepting the applica- of Dr. Thompson in treating Dishman's hand tion of bandages and liniment to the surface, which was wholly ineffective, and afforded no and wrist, to wit, the question of his neglirelief or benefit whatsoever to the plaintiff, or gence in failing to operate upon the hand and to his injured left wrist. That immediately wrist for the purpose of suturing the alleged after the time the plaintiff was injured, and at broken extensor tendons thereof during the all times during the time the plaintiff remained at the hospital of the defendant Northern Pacific two months the case was in his charge. Beneficial Association, the defendants and each of them knew, or by the exercise of reasonable care the said defendants would have known, of the rupturing and severing of the said extensor tendons of plaintiff's left wrist, and that during all of said time the defendants and each of them knew that the only proper treatment for the injured wrist of the plaintiff was by bringing together the broken ends of the said tendons and the suturing and securely fastening the same." This is followed by allegations in substance that, had the wrist and hand been operated upon within a few days following the injury and the severed tendons brought together and sutured, the wrist and hand would have been in a short time rendered strong and useful, that Dr. Thompson's failure to so operate upon the wrist and hand has rendered them

useless, that they will always remain so, and that because of the lapse of time the extensor tendons have so shrunken and lost their vitality that it has become impossible to unite and suture them. That the issue is narrowed to the question of Dr. Thompson's negligence in failing to operate upon the hand and wrist, and suturing the alleged broken tendons, is also rendered plain by remarks of counsel for Dishman made on several occasions during the progress of the trial, such

as:

The following quotations from the testimony of the physicians are taken from the abstract of the evidence, which is for the most part in the usual narrative form, and therefore may not in all cases be the exact words used by the witnesses. However, the correctness of the abstract as a statement of the substance of the testimony, as prescribed by the law and court rules relative thereto, is not challenged. The trial occurred one year and two months after the accident, and one year after Dr. Thompson ceased to have charge of the case.

Dr. Silliman testified in Dishman's favor in part as follows:

"The plaintiff has been coming to my office for treatment for about a year. When he first called upon me, I found a hollow over the wrist. where the band that goes around the wrist had been torn, and some of the tendons that come from the forearm into the fingers had been torn off, and others had been dislocated and out of place. There was more or less displacement of the small bones of the wrist. There are eight bones in the wrist joint, and those had been sprained at the same time that the ligaments and tendons had been torn. The plaintiff told me that he fell in such a way that at the wrist there was a bend where naturally the parts would snap off. The tendons that I have referred to are the long extensor tendons, that stretch out the hand and fingers toward the back. The only method that I know of to treat broken tendons is to sew the ends together as soon as possible; just as soon as the surgeon can get his apparatus together. There is no We do not find in the record before us any tendons have been severed, and I had no diffidifficulty in diagnosing a case where extensor claim of improper treatment by Dr. Thomp-culty in diagnosing plaintiff's trouble when he son other than his failure to operate upon came to me. * and suture the alleged severed extensor tendons. We have thus noticed the nature of Dishman's injury and the negligence of Dr. Thompson, as claimed in behalf of Dishman, at some length, to the end that we have clearly before us the exact issue touching Dr. Thompson's negligence as claimed in Dishman's behalf.

"We are not complaining of any failure to treat broken carpal bones." "We are not complaining of his [Dr. Thompson's] failure to operate upon the bones of the wrist."

164 P.-60

# As I remember, the plaintiff came to me a day or two after he ceased going to the Beneficial Association's hospital-either on the 27th or 28th of February, 1915." "Q. Is it proper treatment, Doctor, of an injured wrist, with broken tendons, such as you found to exist in the wrist of the plaintiff, to fail to suture those tendons and to bring them together for a period of 30 or 60 days afterwards? A. Under no circumstances. When the extensor tendons of the wrist are severed, the

individual loses all strength in his fingers, as far as stretching them out and extending them. The muscles pull up, and the movement is practically lost, except by the use of some small weak muscles between the bones of the fingers. One of the first results of the severing is that they get smaller and shrivel up; then the muscles contract permanently. That makes it more difficult to sew it to the other parts, and then the parts are never in better condition for sewing than they are just after the injury. If they are sewed together later, it is hard to remedy the results, because the parts do not move freely, although you may succeed in sewing the ends pretty well together. After a delay of 30 or 60 days the nourishment is affected, and they have a tendency to shrivel up. The usual result, if an operation is performed immediately, and it is properly done, is that the patient will recover the use of the injured part."

"There was no breaking of the skin, no infection which would be likely to set up an inflammation, with the formation of pus that would complicate the situation, and the results would be less likely to be satisfactory if there had been any inflammation there which had ruptured the parts; but, as there was none, you should expect a favorable result. These injuries are not very common. It is well recognized that they do occur, and that the only treatment is suturing of the ends together as soon as possible."

[blocks in formation]

"Referring to treatment, I would say that there would be some difference in the treatment accorded in case a man had a severed tendon, varying in regard to the various conditions. By that I mean, if there was also a great disturb ance and tearing loose of the ligaments, and breaking of the bones. I would always figure that the greatest injury was the one to be attended first. The carpal bones of the wrist perform a very important function, and sometimes when they are broken we first endeavor to get good apposition, and if that cannot be done it becomes necessary to cut out pieces of these bones. If there is considerable displacement, we might endeavor to get a good apposition. When you ask whether or not, in case a tendon was torn, the doctor himself would determine whether or not he would try to get the tendons in apposition by operation or other methods, I would say it would depend upon his knowledge and experience and own judgment. *

"In order to get the hand upon the level, such as the plaintiff can do, he must have the use of some of the extensor tendons, and the fact that he can get it up on the level, and then can reflex and open his fingers, indicates to me that at least some of the extensor tendons are working. If a man came to me with a hand that he could not overextend, the first thing I would do would be to take a picture, and I would say, if there was no compound fracture, no "Q. And, Doctor, now, or at the time he came opening of the skin, one would not want to stick to you, in your judgment, would it have been a knife in there unless he thought there was possible to have then operated upon his arm some reason for it; and I would say that if a so as to have given him a useful arm? A. I doctor really and honestly felt that he could think it would have been possible. Q. Well treat patients without an operation, and withwould it have been probable? A. It would have out laying open the skin and flesh, that would been probable that the ends of the tendons could be the thing to do. The question as to whether have been sewed together, so that he would have or not a doctor would endeavor to avoid an oppretty fair extension. Q. Why didn't you operation, however, depends on the doctor someerate on him for the purpose of suturing the tendons which you found torn loose? A. I told him that I could not guarantee a perfect result at that time; that the result of the sprain and of the tearing of the tendons and ligaments should have been remedied at once. Q. I know that is what you testified to, but I say why didn't you operate-you had charge of the case, didn't you? A. To a certain extent. He had charge of his own case. Q. Did you recommend an operation? A. I told him that he should be the judge; that he might get good results even then, and he might not, but I would not guarantee good results then."

Dr. Cole testified in Dishman's behalf in part as follows:

Dr. Paschall testified in Dishman's behalf in part as follows:

times. I would state, however, that there are numerous ligaments connecting the muscles and carpal bones of the ulna and radius, and that the wrist and carpal bones are a very complicated structure, and a doctor would hesitate about cutting into the wrist and carpal bones unless it was absolutely necessary; unless he was a very skillful man, he would hesitate. I do not know whether a doctor, finding a great displacement of the carpal bones, and the breaking thereof, and the tearing of the ligaments, would put on splints or not. I do not see wherein he would get very much benefit from the splints. If there was much swelling, he could put on a wet dressing. I would not say, however, that if he did put on splints he did not know what he was doing, because medicine is a matter of "I do most of the X-ray work for Dr. Silli-judgment sometimes, and of experience, and man, and also for other physicians and sur- when a man goes to a doctor it is up to the geons; also lawyers. When I took the picture doctor to use his good honest judgment." and examined the wrist, the tendons on the plaintiff's left wrist appeared to be ruptured. It seemed to be in about the same condition as it is now. I think he told me it was about 60 days after he was injured that I took the picture. The tendons that run over the joint of the wrist appear to be injured or ruptured. The one on the outside seemed to be more plainly ruptured from an examination of the plate. The extensor tendons of the fingers are also broken; I would not say how many, but several. I always consider that a broken tendon is never satisfactorily mended unless it is sutured, as a rule, and usually the time for suturing, if there is not much swelling, is immediately after the injury, or, if there is swelling, after a few days, after the swelling recedes. I would not think that a reasonably careful surgeon would wait a period of 30 or 60 days for suturing tendons, such as I found to be injured in plaintiff's left wrist. I make a specialty of X-ray work, and from an examination of Plaintiff's Exhibit B it would appear that the scaphoid bone had been fractured. All of the carpal bones of the left

"I made an examination of the plaintiff on Friday or Saturday of last week. I also examined the X-ray plate marked 'Plaintiff's Exhibit B,' and all I know about him is limited to the one examination I made and an examination of the X-ray plate, together with what I have seen in the courtroom. As to the condition of his wrist now, it seems to me that all of the tendons which extend the fingers are cut. It would not be absolutely necessary to be cut to have the appearance that the wrist has, but it seems that they are all cut, with the additional tendon here which goes down to the ulnar bone, which is called the extensor crepitum ulnaris. The bones may or may not be fractured. It is rather hard to tell at this late date, although the X-ray looks as if the bones of the wrist had been either broken or separated, and the ligaments torn, to a certain extent.

[ocr errors]

"Repairing of the tendon does not in any way interfere with the healing of the broken bones,

while if the broken bones should heal ever so well, and we did not repair the tendons, the arm or hand or wrist would always be crippled. There is practically only one way of repairing the long tendons. In a very short tendon it is not as necessary, but in a very long tendon, the sooner the ends are sewed together, the better results you will get. You can operate as soon as the inflammation has gone down, which is usually from 3 to 6 days, and every day after that makes it much worse for the patient, and I would say that a reasonably careful and prudent surgeon would not allow tendons to remain for 30 or 60 days without any operation, and he would not do it if he knew it. Even if ruptured tendons are accompanied by fracture of the carpal bones of the wrist, the same treatment would be followed.

"Q. What, doctor, in your opinion, would have been the probability or improbability of his having a well hand, if the operation had been performed at the end of 60 days, basing your answer on the condition which you find the plaintiff's wrist in at the present time, and your examination of the X-ray which has been admitted in evidence? A. I would say that the results would not have been as good as if it was done at once, but would be better than if it was done now. * There would be practically no danger from infection in operating to suture the tendons of the plaintiff's wrist. A surgeon can never do any harm by making a nick. I mean, if there is any doubt, in a modern hospital, you never can do any harm in cutting open a man and looking in. There is no argument against early operation in case of doubt.'

Dr. Mowers, chief surgeon of the Beneficial Association's hospital at Tacoma, testified in Dr. Thompson's behalf in part as follows:

"Mr. Dishman came to the hospital on December 28, 1914, and was treated as an office case by Dr. Thompson. The injury to the wrist was treated by keeping the wrist immobilized by splints. He came in from time to time, and the splints were removed and fresh dressings reapplied. * When Dishman first came to the hospital, the wrist was treated by Dr. Thompson, who called me to see the wrist about January 25th, at which time he showed me the X-ray plate and explained to me the treatment which he was giving him. I examined the wrist carefully at this time; it was swollen and tender. He was able to extend the wrist on the forearm, and the only limitation in the movements was an inability to completely overextend. There was a fracture of one of the carpal bones, and a depression over the insertion of the tendon of the extensor carpi radialis brevior, indicating a probable tear of this ligament. From the history of the injury and from the examination there had evidently been a severe stretching and probable tearing of the numerous ligaments uniting the small bones of the wrist. At the time I saw this man, this had not yet repaired, as was indicated by the swelling. I did not at that time consider it would be advisable to attempt to suture the tendon, which was probably torn. Owing to the injured condition of the tissues, there was great danger of infection, which would not only prevent the healing of the tendon, but would possibly do very serious damage to the wrist. Furthermore, at this time there was no evidence, so far as the motion of the wrist was concerned, of any bad results following from the tear. The injured condition of the ligaments between the small bones of the wrist was not one which could be treated surgically at all. At this time the hand was again splinted, on my advice, and I saw him about a month later. At this time the condition of the wrist was practically the same as at my former examination. The swelling was somewhat lessened. He was still able to move the wrist in any direction, excepting that he still could not

completely overextend. A sufficient time had elapsed to warrant the removal of the splints, and I advised that these be removed, and that he be treated by means of liniments and massage to the wrist, in order to see how much the wrist would improve in this way. Later on, if necessary, an attempt could be made to suture the tendon. I did not believe at any time that the best results to the wrist would warrant operative procedure. Dishman did not return to the hospital after the splints were removed, to the best of my knowledge. It is my professional opinion, as a physician and surgeon, that the treatment accorded to the plaintiff by Dr. Thompson was in accordance with good medical practice. * I think the wrist will be weak, owing to the injury of the ligaments of the wrist joint, not from injury to the tendons. In my opinion, no man with an injury to the small bones of the wrist, such as Mr. Dishman had, would ever have a wrist as strong as it was before the injury."

Dr. Argue, first assistant surgeon of the Beneficial Association's hospital at Tacoma, testified in behalf of Dr. Thompson in part as follows:

"As near as I recollect, the first time I perSonally examined the plaintiff's hand was at the time Dr. Mowers and Dr. Thompson were examining it in the X-ray room of the hospital. At that time [about January 25th] I also examined what X-ray plates had been taken, and remember of seeing from the plates one or more of the carpal bones broken in the wrist. At that time I remember of Dr. Mowers testing out the function of the tendons of the forearm

*

of the wrist, and at that time the plaintiff had the ability to extend the hand on the wrist, on the level with the forearm, and to extend the fingers on the hand. * A fracture of a carpal bone is considered a serious fracture. * I have examined plaintiff's hand in court, and also examined it in the hospital, and I have examined the various X-ray plates and, based upon my examinations of the hand and the X-ray plates, I would state that I have never yet seen any reason for believing that there were any ruptured tendons in the plaintiff's injured hand.

"Q. Doctor, will you please state to the jury, based upon your learning, examination of authorities, and experience as a surgeon, the propriety of cutting into a wrist or a joint where there is no compound fracture, in cases where there are fractures of the carpal bones of the wrist more particularly, or of any of the bones going to make up the joint? A. I would consider it poor practice to cut in and produce a compound fracture in the carpal bones at an early date, for any purpose whatever. The reason for it would be the danger of infection. Where small bones are fractured, we find, if it is a compound fracture that is, where the skin is broken; that is what we call a compound fracture, where the skin is broken; that is, the fracture communicates with the open world-in such a case it is a frequent occurrence to have bone necrosis take place. Bone necrosis is the death of bone; it does not live. Consequently the fragments have to be taken out later on. On account of this risk, I think it is poor practice to convert a simple fracture into a compound fracture, especially in the presence of small bone. *

"From my examination of the plaintiff's hand in the hospital, and examination of the X-ray plates, and the history which he gave, in my professional judgment, the proper treatment would be that of immobilization of the hand and wrist joint and forearm on a splint for a considerable time, which varies in individual cases. In this case I would keep it in a splint at least 30 days, and follow by massage and passive motion, to get the joint, as well as the ligaments and muscles and tendons, limbered up

« ÀÌÀü°è¼Ó »