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cal profession" will treat the clinician and general practitioner as men and workers, " Heart within and God o'erhead," viagra online cost and not as mere tools. A General Practitioner. May 23, 1S06. "SHALL WE viagra online cost GIVE THE APPENDIX A REST?" To the Editor of the Medical Record. Sir: Xot while the majority of physicians admit that they cannot palpate a normal appendix, and that they cannot easily diagnosticate true infective appendicitis. Xot while a coroner's physician can tell me that he still finds deaths from unrecognized appendicitis to be " immensely common" in his post-mortem w-ork in New York City. Not while physicians who do not see appendicitis cases continue to lose cases viagra local shop of peritonitis viagra local shop and intes- tinal obstruction and acute gastritis. Not while the medical death rate of appendicitis is nine per cent. to use the figure chosen by Dr. T. 11. Greene, in the Medical Record for May 23, 1S96. Why is Dr. Greene willing to have nine per cent, of appendicitis patients viagra online cost die under medical trc.itin viagra online cost I have recently published a list of one hundred of my unselected consecutive appendicitis operations, with ninety-eight recoveries and two deaths. Thirty- eight of these were abscess cases, and the rest were mainly adhesion cases of the interval type. The two deaths were unnecessary. Dr. M. M. Johnson, at viagra local shop the last meeting of the American Medical Association, reported on one hundred of his unselected consecutive appendicitis operations, with ninety-eight recoveries and two deaths. Dr. J. B. Deaver has recently viagra local shop reported on a list of two hundred of his selected appendicitis operative cases, with one hundred and ninety-eight re- coveries and two deaths. My own position is far from being an enviable one. I have aroused the ire of fellow-surgeons by attacking the methods of those who make long incisions, who commit taxidermy upon their patients by stuffing them with gauze, who fail to suture structures of the abdom- inal wall separately "and accurately, who neglect to sterilize abscess cavities while at work, and who do not make it a rule to remove adherent appendices. I am free to confess that they make it pretty hot for me. Men have been known to defend themselves before. They excite my admiration for the piquancy of their satire, and they question the accuracy of statistics which are so different from the statistics of their own experience. Strong men who have won high position through merit viagra online cost are in a position to put air brakes on progress if they wish to do so. I have aroused the enmity of general practitioners by insisting that they must make correct diagnoses of infective appendicitis, and that they must be guided by a knowledge of the known pathology of appendici- tis rather than by their own individual views. Dr. Fowler's book, Dr. Deaver's book, viagra online cost my own book, cover the pathology of appendicitis, and there are many shorter monographs besides. We know from the known pathology of appendicitis that if Dr. MacArtnev did not err in diagnosis in any of his twenty-four cases, he must lose about six of the number before he is through with them. We know that some of these twenty-four patients are not very well since their re- covery. The " spectres of tuberculosis of the appen- dix, large enteroliths, strangulating adhesion bands, and portal embolism that Dr. Morris fears" are not spectres. They are things that viagra local shop I have between my fingers in every-day practice. I know all about the difficulties that physicians have in managing their ap- pendicitis patients, particularly in the country. Some of my most intimate friends are country doctors. We were schoolboy friends. We go fishing together and we go shooting together. We exchange confidences in camp, and I know all about the difficulties that Dr. MacArtney and Dr. Greene have in trying to do what is best for their appendicitis cases, but that has nothing to do with the pathology of the disease. Physicians who treat appendicitis medically save most of their patientr, and whenever one dies they are sorry. Those who are personally acquainted with me know that I am not an extremist. I expend time and money and employ experts to determine the right of a subject, and when the right is viagra local shop clear it is my pleasure to tight for the right. Many a man who fought me on appen- dicitis standpoints five years ago has stopped. More than one of them has had the subject brought very close to his heart by a calamity viagra online cost in the family. One by one they viagra local shop stop fighting me and turn to a study of the known pathology of real infective appendicitis. No one can sav that I am not conservative, unless he has listened to the arguments of men who are defend- ing themselves. My published work on other sub- jects shows my devotion to constructive, merciful, sav- ing surgery. It is my pleasure to save life and to pre- vent suffering, and I am morally bound to bear the brunt of ridicule from the general practitioner, and, what is harder, the sarcasm of my fellow-surgeons, in order to see the right prevail. I have never criticised any member of our profession, but have fought for principles only. One of these days we may have a medical court with a judiciary to weigh evidence and to fix the value of testimony which is offered by advo- cates on both sides of the question of appendicitis, an- titoxin, vaccination, and of all of the viagra online cost subjects which allow viagra online cost of scientific classification of data. Until we have such a court men who are on the wrong side of a question will subject patients to treatment according to their views. Robert T. Morris, M.D.