Mother Essay

does it seem within the bounds of reason that substitutionis so commonly practiced by pharmacists that this firm must go tolarge expense to prevent the substitution of spurious mixtures for itsproduct?. is dishonesty the rule among pharmacists?. common sense rejectsthe plea as placing too great a strain on one credulity obviously, then, the advertisement does not tell the whole truth, though it doesindeed tell exactly what the nostrum maker wishes to have done, thatis, to have only original bottles dispensed when physicians prescribethat nostrum the fact we have. The reason is not far to seek illustrationwhen the pharmacist puts up an ordinary, nonproprietary prescription, the patient gets no clue from the package as to the nature of theprescription employed but when an original bottle of neurosine isdispensed, even though the pharmacist puts his own prescription labelon it, the patient sees the difference at once and knows just whythe usual prescription bottle was not employed he also knows thathe can get the medicine with its original wrapper or label by merelyshowing the bottle to the druggist, for the words “neurosine” and “dioschemical co ” are blown in the glass here, then, may be a plausiblereason for desiring that only original bottles be dispensed you may ask, “what difference does it make if the patient does learnthe name of the nostrum, he must go to his physician for adviceconcerning its use?. ” having learned the name of the remedy that hasbeen prescribed for sleeplessness, let us say, he proceeds to useit whenever he imagines that he needs it. And that need, real orimaginary, has a way of increasing in frequency as a result, thepatient takes far more neurosine than the physician would think ofpermitting if the matter had not passed entirely beyond his control not only has the patient acquired a dangerous habit ofself-prescribing, but he takes especial delight in recommending hisfavorite remedy to friends whose symptoms, real and imaginary, seem toresemble his own this offers him an opportunity to prescribe with anair of authority it was prescribed for him by dr blank, and it gaverelief, ergo it may be depended on to give relief to others!. thus isthe basis laid for its general use by the laity, when this process ismultiplied sufficiently the statement is susceptible of easy proofby any one who cares to investigate the matter for himself there isprobably no physician worthy of the name who will attempt to denythat the promiscuous use of hypnotics and narcotics is dangerous, andcertainly no careful physician will deliberately place a narcotic inthe hands of patients to be used freely and without control since we have selected neurosine at random, so far as this writingiculardiscussion is concerned, it is worth while to inquire into itscomposition, the claims that have been made for it and the evidence, ifany exists, for or against its therapeutic value even the most activeof hypnotics are worse than useless if they are inferior to otherreadily available hypnotics, or if they have undesired side-actionsthat outweigh any advantages that they might otherwise have the council on pharmacy and chemistry investigated the literaturerelating to neurosine and published its report in the journal, jan 9, 1915, p 165 according to this report the manufacturers of neurosineclaimed that each fluidounce contained. Bromid of potassium, c p 40 grains bromid of sodium, c p 40 grains bromid of ammonium, c p 40 grains bromid of zinc 1 grain extract lupulin 32 grains cascara sagrada, fl ex 40 minims extract henbane 0 075 grain extract belladonna 0 075 grain extract cannabis indica 0 60 grain oil bitter almonds 0 60 grain aromatic elixirthis chemical blunderbuss was recommended for use in insomnia, hysteria, neurasthenia, migraine, neuralgia, delirium tremens, epilepsyand thesis other conditions also it was called an ideal calmative forchildren suffering from chorea, the exploiters claiming that “allauthorities recommend the bromids, hyoscyamus and cannabis indica inthis disease ” oliver t osborne, professor of therapeutics in yalemedical school, does not mention one of these three drugs in hisdiscussion of the medicinal treatment of chorea, in the handbook oftherapy, though he quotes several authorities in this article indeed, he does not mention one of the ten drugs included in the above formulaof neurosine in connection with the treatment of this disease it is acurious fact that osborne gives the greatest prominence to the use ofthat drug which is claimed to be wanting in the formula of neurosine, namely, hydrated chloral perhaps you may have seen temporary relief follow the administrationof neurosine in chorea, and may argue that theorizing is of littlevalue in the face of personal experience we shall not deny that essaymay have had that experience, for osborne calls attention to the factthat the success of any medicinal treatment must be judged in thelight of the fact that chorea is self-limited, and the intensity ofthe symptoms will abate in from two to four weeks in view of this, wewould hardly dispute the claim that one may administer narcotics, suchas those contained in neurosine, and the symptoms of chorea may abatein spite of such mistreatment in all the years that neurosine has beenexploited to physicians with such remarkable claims, we have never seena report of a careful clinical study in which the product has been usedunder the conditions which scientific investigation demands would youprescribe any nonproprietary preparations which had never been studiedclinically, if a horse-shoer or grocer boy told you it would cureepilepsy or malaria?. According to an editorial note appended to the report of the councilon neurosine, the dios chemical company consisted at that time 1915of j h chambers, his wife and two sons it appeared that chambersnever claimed to have any special knowledge of chemistry, pharmacy ormedicine, yet we find that he arrogated to himself or to his employeesthe right to offer therapeutic advice to the medical profession, andeven to direct them as to how they should prescribe a given mixture we essaytimes fail to see the forest because of the trees it may helpus to obtain a better perspective, in a problem that concerns usintimately, by resorting to a hypothetic case, if a close analogy ismaintained in order that we may see ourselves as others see us insuch a situation, let us consider the following imaginary case.

Nor much beating, for the finer powder provokesvomits and urine, and the coarser mother essay purgeth downwards the common use hereof is, to take the juice of five or seven leaves ina little drink to cause vomiting. The roots have also the same virtue, though they do not operate so forcibly. They are very effectual againstthe biting of serpents, and therefore are put as an ingredient bothinto mithridite and venice treacle the leaves and roots being boiledin lye, and the head often washed therewith while it is warm, comfortsthe head and brain that is ill affected by taking cold, and helps thememory i shall desire ignorant people to forbear the use of the leaves. Theroots purge more gently, and may prove beneficial to such as havecancers, or old putrified ulcers, or fistulas upon their bodies, totake a dram of them in powder in a quarter of a pint of white winein the morning the truth is, i fancy purging and vomiting medicinesas little as any man breathing doth, for they weaken nature, norshall ever advise them to be used, unless upon urgent necessity ifa physician be nature servant, it is his duty to strengthen hismistress as much as he can, and weaken her as little as may be asparagus, sparagus, or sperage descript it rises up at first with divers white and green scalyheads, very brittle or easy to break while they are young, whichafterwards rise up in very long and slender green stalks of the bignessof an ordinary riding wand, at the bottom of most, or bigger, orlesser, as the roots are of growth. On which are set divers branches ofgreen leaves shorter and smaller than fennel to the top. At the jointswhereof come forth small yellowish flowers, which turn into roundberries, green at first and of an excellent red colour when they areripe, shewing like bead or coral, wherein are contained exceeding hardblack seeds. The roots are dispersed from a spongeous head into thesislong, thick, and round strings, wherein is sucked much nourishment outof the ground, and increaseth plentifully thereby prickly asparagus, or sperage descript this grows usually in gardens, and essay of it growswild in appleton meadows in gloucestershire, where the poor peoplegather the buds of young shoots, and sell them cheaper that our gardenasparagus is sold in london time for the most writing they flower, and bear their berries late inthe year, or not at all, although they are housed in winter government and virtues they are both under the dominion of jupiter the young buds or branches boiled in ordinary broth, make the bellysoluble and open, and boiled in white wine, provoke urine, beingstopped, and is good against the stranguary or difficulty of makingwater. It expelleth the gravel and stone out of the kidneys, andhelpeth pains in the reins and boiled in white wine or vinegar, it isprevalent for them that have their arteries loosened, or are troubledwith the hip-gout or sciatica the decoction of the roots boiled inwine and taken, is good to clear the sight, and being held in the moutheaseth the toothache the garden asparagus nourisheth more than thewild, yet hath it the same effects in all the afore-mentioned diseases the decoction of the root in white wine, and the back and belly bathedtherewith, or kneeling or lying down in the same, or sitting thereinas a bath, has been found effectual against pains of the reins andbladder, pains of the mother and cholic, and generally against allpains that happen to the lower writings of the body, and no less effectualagainst stiff and benumbed sinews, or those that are shrunk by crampsand convulsions, and helps the sciatica ash tree this is so well known, that time would be misspent in writing adescription of it. Therefore i shall only insist upon the virtues of it government and virtues it is governed by the sun. And the youngtender tops, with the leaves, taken inwardly, and essay of themoutwardly applied, are singularly good against the bitings of viper, adder, or any other venomous beast. And the water distilled therefrombeing taken, a small quantity every morning fasting, is a singularmedicine for those that are subject to dropsy, or to abate thegreatness of those that are too gross or fat the decoction of theleaves in white wine helps to break the stone, and expel it, and curesthe jaundice the ashes of the bark of the ash made into lye, and thoseheads bathed therewith which are leprous, scabby, or scald, they arethereby cured the kernels within the husks, commonly called ashenkeys, prevail against stitches and pains in the sides, proceeding ofwind, and voideth away the stone by provoking urine i can justly except against none of all this, save only the first, viz that ash-tree tops and leaves are good against the bitings ofserpents and vipers i suppose this had its rise from gerrard or pliny, both which hold that there is such an antipathy between an adderand an ash-tree, that if an adder be encompassed round with ash-treeleaves, she will sooner run through the fire than through the leaves:the contrary to which is the truth, as both my eyes are witnesses therest are virtues essaything likely, only if it be in winter when youcannot get the leaves, you may safely use the bark instead of them thekeys you may easily keep all the year, gathering them when they areripe avens, called also colewort, and herb bonet descript the ordinary avens hath thesis long, rough, dark green, winged leaves, rising from the root, every one made of thesis leaves seton each side of the middle rib, the largest three whereof grow at theend, and are snipped or dented round about the edges. The other beingsmall pieces, essaytimes two and essaytimes four, standing on each sideof the middle rib underneath them among which do rise up divers roughor hairy stalks about two feet high, branching forth with leaves atevery joint not so long as those below, but almost as much cut in onthe edges, essay into three writings, essay into more on the tops of thebranches stand small, pale, yellow flowers consisting of five leaves, like the flowers of cinquefoil, but large, in the middle whereof standa small green herb, which when the flower is fallen, grows to be round, being made of thesis long greenish purple seeds, like grains which willstick upon your clothes the root consists of thesis brownish strings orfibres, smelling essaywhat like unto cloves, especially those which growin the higher, hotter, and drier grounds, and in free and clear air place they grow wild in thesis places under hedge sides, and by thepath-ways in fields.

Whether the purport was suicidal orhomicidal. How much blood was lost. Whether the weapon was near to orat a distance from the body when fired. Whether it were possible thatthe deceased could have fired it himself. Whether after the receptionof the wound the person could have moved or performed any act in otherwords, whether death was instantaneous he may be asked also as togenuine or spurious blood-stains, whether genuine blood-stains werehuman or from essay other animal. Whether possibly they were from thebody of the deceased he will be expected to tell from what directionthe bullet or missile was fired. Which the wound of entrance and whichof exit, and thesis other things possible concerning the circumstancesunder which death occurred it is unnecessary to state that questionsof this nature call not only for conventional surgical skill, but forthe highest degree of shrewdness and general information, as well asessaytimes for expert knowledge with regard to small-arms and theirballistics it has been well said that the first duty of a medical jurist is tocultivate a habit of minute observation when this is combined with aknowledge of what the law requires and with the results of a technicaleducation, he will be able to meet all or nearly all of the scientificquestions which may be asked of him a learned judge once said that“a medical man when he sees a dead body should notice everything ”certainly he should make a minute scrutiny of the body to note whetherthere are upon the dress or hands of the deceased marks of blood, orwhether blood-stains are noted in different writings of the room. Whetherthe body or any writing of it is cold or warm. Whether the limbs are coldor rigid or pliant, since by these means the accurate date of death maybe more accurately determined examination and description in determining facts attending a suspicious case of gunshot wound, there should be noted, if known, 1st, the exact time of death, aswell as of infliction of the wound. 2d, location and attitude of thebody. 3d, condition of clothing. 4th, anything of importance in itsenvironment. 5th, external appearance of the body, as well as stateof countenance. 6th, exact description of all marks of violence andof blood-stains. 7th, the presence of cadaveric rigidity and thesurface upon which cadaver has been lying, as well as its age andcondition of general nourishment. 8th, time when deceased was lastseen alive or known to have been alive. 9th, time after death at whichexamination is made.

The ossification of the sternum andof the costal cartilages is very uncertain, while the teeth, likecertain railway trains, are only due when they arrive from the character of the progress of consolidation of the skeletonthe age may be estimated with a reasonable approach to accuracy up totwenty-five or thirty years, which is the stationary period as regardsalteration in the osseous system above this period it is difficultto arrive at the age about forty the cranial sutures576 begin todisappear, although the time of the closure of the sutures varieswithin large limits. The coccyx becomes consolidated. Ossificationbegins in the thyroid cartilage and in that of the first rib althoughthis state of the rib is regarded by thesis as pathological. Thelower jaw, which in the fœtus and in infancy formed an obtuse angle, now assumes nearly a right angle as senility progresses towarddecrepitude, the bones become lighter and more brittle, owing tofatty atrophy, and their medullary canal larger. The jaw returns toits infantile shape from loss of teeth and atrophy of the alveolarprocesses. The bodies of the vertebræ according to essay authoritiesbevel off in front. Osteophytes are formed, and the neck of the femurapproaches the horizontal see abortion and infanticide determination of sex in the matter of sex there should be no difficulty, after noting theproof furnished by the aggregate characteristics of both male andfemale skeletons the points of contrast between the two skeletonsare not so striking before the age of puberty generally speaking thecranial capacity of an adult woman is less, although it is contendedthat since the great majority of males of the human species are taller, heavier, and larger than the females, it follows that if due allowancebe made for these variations, it will appear that the brain capacityof woman is relatively very little, if at all, inferior to that ofman the mastoid processes of the female skull are smaller. The lowerjaw-bone is relatively smaller and lighter. The ribs are lighter andcompressed. The spine is relatively longer. The collar and shoulderbones and the sternum577 are smaller and lighter.

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Pedgrift v schiller, 8 c b , n s , 200 same case, 6 jurist, n s , mother essay 1341 andif he simply practises “massage, ” he does not fall within the actsagainst practising medicine, even though he pretends to accomplish asmuch good as could have been accomplished by a regular physician smithv lane, 24 hun, n y , 632 but see also leech v ripon, 12 cent l j , 479. State v schultz, 11 reporter, 701 160falsely pretending to be a licensed practitioner generally amisdemeanor - in essay of the states, and in england, it is notonly made a misdemeanor to practise without a license, but falselypretending to be a licensed practitioner is made a misdemeanor suchis the provision of the penal code of new york heretofore cited inengland such a statute has been essaywhat strictly construed in thecase of carpenter v hamilton 37 law times rep , 157 in thatcase it appeared that a person advertised himself as “john hamilton, m d , ” of the “metropolitan medical college of new york ” it furtherappeared that he was not registered as required by the law of england in a prosecution against him for falsely pretending to be a licensedphysician, the only proof of his practising being as just stated, anacquittal was sustained by a majority of the court, which held that itwas a question of fact to be determined by a trial court whether ornot what he did was pretending to be a physician authorized to treata patient the court intimated that the person simply pretended to bewhat he really was, namely, a doctor of medicine of the metropolitanmedical college of new york state and local boards of health powers governed by special statutes in addition to the rules and regulations prescribed by the generalstatutes, modern sanitary science has developed so broadly throughoutmost of the civilized states and countries, that the differentgovernments have established state boards of health, and in thesisinstances local boards of health, the latter being limited in theirauthority and operation to specific municipal divisions, to whichboards the government has committed the power to pass certain sanitaryrules and regulations, which rules and regulations may have animportant bearing upon and relation to the practice of medicine andsurgery the jurisdiction and powers of these boards are to be foundin the special statutes creating them, and prescribing their powersand duties, and cannot be treated of extensively here they will beconsidered further under the special subjects to which they relate physicians bound to report contagious paper and not liable formistaken report - the duty to promptly report161 to boards ofhealth every case of contagious or infectious disease is manifest chapter iii of the contractual relation between physician and patient employment and rights in regard to compensation legal character of the employment - whatever may have been thetheories of the roman civil law, and following it of the early englishcommon law, as to the character of the employment of physicians andother professional men, it is now so well settled that the reciprocalduties and obligations arising between physician and patient, orattorney and client, and the like, are to be classed under andgoverned by the law of contracts, that any extended discussion ofthese theories is unnecessary here 162 mr ordronaux, in the secondchapter of his interesting work on the “jurisprudence of medicine, ”has considered them fully, and has quoted amply from the books of theearlier and later text-writers, and from the expressions of the judges, to show what these theories and rules were. And he and all laterauthorities agree that the ancient notion, that professional servicesare always gratuitous unless a special contract to pay for them ismade, has long been abandoned he observes pp 13 and 14. “but inour day the increase in the number of professional practitioners, andtheir exclusive devotion to a special class of services as a meansof living, has essentially modified the practical character of thecontracts with their patrons although in legal acceptation a mandate, yet from force of circumstances growing out of an altered state ofsociety, the mandate is practically changed into a contract of hire locatio operis this doubtless reduces professions to the statusof artisanship, and places them on a par with manual labor, conjoinedto the special skill of a writingicular calling but it also simplifiesthe contract, removes it from the category of innominate or imperfectobligations, requiring the intervention of legal fictions to furnisha means for their enforcement, and brings it within the pale ofconsensual agreements based upon a sufficient consideration ”the physician right to sue on contract in england was declared bylegislative enactment by chap 90 sec 31, 21 and 22 victoria it hasnever been denied in the united states adams v stephens, 26 wend , 451-455 physicians’ and surgeons’ service in a sense voluntary - though itis true, as in the case of thesis other doctrines of ancient law whichwere formulated under social conditions far different from those whichprevail in modern times, that these rules and theories have longsince lost their potency as distinct rules governing actions at law, nevertheless the legal aspect of the peculiar relationship betweenphysician and patient, is still affected by the idea that the serviceon the writing of the physician is voluntary that is, the physician orsurgeon is not bound to come and perform services whenever or whereverhe is called he is at liberty to refuse any and every patient whoattempts to employ him patients may cease employing at any time, unless there is a contractfor a certain period - and when he is employed, the patient may at anymoment discharge him, without incurring liability in damages, unless aspecial contract has been entered into between them that the servicesshall be rendered for a fixed period service once begun by physician must be continued until notice ofintention to cease is given by him - if, however, the services arebegun, they must be continued until notice has been given of theintention to discontinue them, and a reasonable time allowed thepatient to obtain the services of another person the reasons for thisrule will be considered more fully below contracts either express or implied - the contract between thephysician and patient may be an express one, that is, one in which allthe terms are agreed upon or expressed between the writingies, or it maybe what is called an implied contract, or one in which the patient, oranother person, simply calls on the physician or surgeon to come andperform services, and neither writingy specifically stipulates or agreesupon any of the terms of the employment express contracts may include any stipulation not contrary to publicpolicy - in the case of an express contract the agreement of thewritingies settles and determines their mutual obligations, whether itbe written or merely verbal but an express contract may also be madein such a form that certain conditions are required to be performedby the physician before he becomes entitled to any compensation forhis services it may also embody an agreement that the patient shallpay certain sums at certain times as the treatment goes on, or that noother physicians shall be employed without the consent of the attendingphysician, or if so employed that they shall be under the direction ofthe attending physician almost anything may be stipulated which is not contrary to publicpolicy, and a breach of any such stipulation entitles the aggrievedwritingy to rescind the contract and cease from performing it 163qualifications of the rule that express contracts may include anystipulation - essay qualifications of this rule of law must, however, be noted a breach by the patient of any one of these stipulationswould entitle the physician to treat the engagement as terminated likeany other contractual relation, and to bring his action for a recoveryfor services rendered up to the time of the breach. But it is doubtfulwhether he would have any action for damages for failure to permit himto perform further services this doubt arises from the legal doctrine, hereinbefore referred to, that a patient is always at liberty todismiss his physician at any time without notice, and without assigningany cause, which recognizes and grows out of the fact that if the trustand confidence of the patient are destroyed, or impaired, no matter howunreasonably or unjustly, the relation between them must thereafterbe unprofitable to both writingies, and dangerous to the patient on theother hand there is little doubt but that whenever an express contractis made by a physician to treat a patient for a certain length of timefor a writingicular disease or injury, the physician is not at liberty toarbitrarily terminate that relation or his connection with the case, unless he has in the contract specifically reserved the right so to do contracts making payment contingent upon successful treatmentvalid - the express contract between the writingies may also contain astipulation, by which the physician makes his compensation contingentupon his effecting a cure smith v hyde, 19 vt , 54. Mack v kelly, 3 ala , 387 see also coughlin v n y cen r r co , 71n y , 443 in such a case, however, if the patient does not permitthe physician opportunity to treat him during the time named in thecontract, or for a reasonable time, if no specific time is fixed, thecourts would probably permit the physician to recover a reasonablecompensation for his services for the time during which he treated hispatient physician must allow reasonable time to supply his place if hequits his patient - in any event, whether the contract be expressor implied, conditional or unconditional, the law through motives ofpublic policy, and with a just regard for the welfare of the sick andinjured, undoubtedly requires that if a physician has once taken chargeof a case, and determines to abandon it, he must give the patientreasonable notice and reasonable opportunity to supply his place if hefails to do this he is liable in damages for the results that follow asthe proximate consequence of his abandoning the case this rule true even in the case of a charity patient - this is true, it is believed, even when the patient is a charity patient, and theservices are gratuitous shiels v blackburn 1 h blacks , 159 forany other rule less strict might entail the most serious consequences ordronaux, “jur of med , ” 13 and 14, citing inst , lib 3, 26, 11;pothier, “du contrat mandat, ” chap i , § 4 elements of the contract between physician and patient duties of physician - when the relations between physician andpatient are not defined otherwise by express contract, the impliedcontract is, and the law presumes, that the physician contracts, first, to use the necessary care and attention. Second, to use the necessaryskill. Third, in case the physician furnishes his own medicines andthe obligation to furnish them would probably be imposed, if it was thecustom of the school or class of physicians to which the writingicularphysician belonged to do so, that the medicines are proper andsuitable as a corollary of these duties it necessarily follows, also, that the physician contracts that the instruments or appliances whichhe uses are free from taint or contagion, and are suitable and properfor the uses to which they are put upon this theory an action could bemaintained against a physician for using impure vaccine duties of patient - the patient on his writing contracts, first, togive the physician information concerning the facts and circumstancesof the case, and full opportunity to treat him properly. Second, toobey his instructions and follow his directions, and, third, to payhim the reasonable worth and value of his services the differentbranches of this contract are reciprocal the failure of either writingyto fulfil the obligation of any one of them which is imposed uponhim, would bar him of his remedies against the other writingy to recoverdamages for any breach, or any proximate result of his breach, ofsuch obligations the necessary care and attention required of thephysician in such a case are measured by the requirements of the caseand the physician duties to his other patients, modified, however, by the rule that the physician is presumed to know, at the time hetakes up the case, the condition and situation of his other patientsat that time consequently, if those who have first employed him areso situated at the time that his services for them are likely to besoon and continuously required, he cannot without making himself liablein damages undertake another case and then neglect it, but he shouldeither decline to take it, or should with the full knowledge andconsent of the patient make provision for the temporary substitutionof essay other physician, during the time that his prior obligationsengross his attention nevertheless, if the situation and condition ofthose to whom he has first contracted his services is such that he had, although he exercised due professional knowledge and skill, no reasonto apprehend that these patients would need his exclusive service, and by a sudden development, arising from those occult causes whichobtain in all serious diseases and injuries, any of his prior patientssuffer a sudden and dangerous relapse, or from an accession of new anddangerous symptoms and conditions so that he must fly to their aid, he would not be liable to another patient, to whom he had afterwardcontracted his services, for neglecting his case. Still he should insuch instances use extra means to obtain the services of essay other andequally skilful man only ordinary and usual skill required - the degree and characterof necessary skill contracted for has been variously defined by thecourts when malpractice is discussed, a more extended considerationof this matter will be required at present the doctrine laid downin shearman and redfield on “negligence, ” paragraphs 433-435, may beadopted it is as follows:“although a physician or surgeon may doubtless by express contractundertake to perform a cure absolutely, the law will not imply sucha contract from the mere employment of a physician a physician isnot an insurer of a cure, and is not to be tried for the result ofhis remedies his only contract is to treat the case with reasonablediligence and skill if more than this is expected it must be expresslystipulated for the general rule, therefore, is, that a medicalman, who attends for a fee, is liable for such want of ordinary care, diligence or skill on his writing as leads to the injury of his patient to render him liable, it is not enough that there has been a lessdegree of skill than essay other medical man might have shown, or a lessdegree of care than even himself might have bestowed.