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r.4.V DE IfARKER: SURGICAL PARADOX. 1053 ing instead of b}- training. He believes that he has followed every step when he has not. What appears to him as so very simple is really compli- cated, but its complexity' has escaped him. It is not unusual for him to return to his home firmly convinced that there is a lot of nonsense in so much antiseptic fuss over so simple an opera- tion. He has been taught and what is teaching for unless to enable him to use his mind? I have seen these men operate and I have been convinced that their preparation of the patient was regarded as a waste of time. Take the dilator, for instance. Our author can teach its use and the belated post- graduate can see him use it, but can any form of teaching yet devised convey to his mind, not the degree of force that he ought to use, but the actual amount that he is exerting with the instrument? The curette, blunt or sharp, is another thing that he is taught, not trained, to use. I have long ago defined practical gynsecology to be simply a high- ly trained and differentiated sense of touch. Can fingers which have never acquired this gain any idea of consistence or resistance with such a touch prolonged to the end of a steel wire? This cannot be Buy Atrovent taught, it must be acquired by training. It is doubtful if the author has Buy Aerovent added anything to the general belief in the Cheap Atrovent safety of uterine Order Atrovent Online cu- rettement by referring to the frequency of puncture of the walls of the organ without evil results. Al- ready there is a growing tendency to belittle the dangers of the operation. We all know that such accidents do happen even with experienced oper- ators. This fact alone, if we had no others, is sufficient to prove that there are positive and in- herent dangers in the operation. I .think Dr. Craig hardly grasped the motive of my Purchase Atrovent paper. It was simply this : that college and postgraduate teachers, as well as the textbook writers, regard the operation too lightly. They have minimized its dangers to very nearly a negligible quantity. Very little is said to caution the untrained man that he is dealing with a dangerous procedure. We will always have the untrained operator with us, and there are no conscientious, trained sur- geons who do not deplore Atrovent Online the fact. The social and professional reasons that in- duce men at or after middle life to attempt sur- gical work have been very active during the past ten or twelve years. If we search for an explana- tion it takes us beyond professional or ethical lim- its. It becomes a problem in sociology and shows Generic Atrovent a strange lack of discrimination on the part of those who have to select a surgeon. The readi- ness with which men and women, especially the latter, submit to operations is only equalled by their indifference concerning the fitness of the operator. It is all difficult to explain, unless it may be an upheaval on the surface of the exist- ing social order of a primordial civilization that held human life cheap. Our author teaches the young men and his skirts are free from the odium which, according to Dr. Kelse)-, belongs to the postgraduate teacher. His responsibility, how- ever, does not end with teaching surgery. The young graduate should be given a high standard of surgical attainment. He should be surgically trained as well as Purchase Atrovent Online surgically taught. Dr. Craig's contention that the operation is safe in trained hands fails as a criticism of my position that certain Buy Cheap Atrovent dangers belong to the opera- tion per se, since he admits that perforation may occur to the most experienced operator. The only advantage that the man of experience would have over the surgical novice or general practi- tioner would result from the fact that he would know how to deal with it, while the other man would open the abdomen and attempt to sew up the uterine rent, which might be comparatively safe if he knew enough to let it alone. Further, a man may be a fairh' safe ovariotomist, hysterec- tomist, appendectomist, and yet make a veritable fool of himself when he attempts the dangerous operation of uterine curettement. This is the operation that belongs to the general practitioner and to the belated surgeon, and which he is en- couraged to attempt by Order Atrovent the textbooks for stu- dents and general practitioners, usually written by men in Dr. Buy Atrovent Online Craig's position, or by articles in the journals, so cheerfully optimistic in the in- terest of the inexperienced surgeon that the most serious complications are charged up to the trained surgeon on equal terms with the untrained. This is, to say the least, a dubious way to encourage the untrained surgeon to seek faithfully to do his

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