tigate the condition of our schools, and to give this subject your best thought, and to use your influence energetically for reforms that will correct the evils of our educational methods. My intention has been not so much to suggest remedies, as to call attention to the conditions and to set you to thinking. When we have attained a system of education which shall permit and promote the natural evolution of the whole human creature without undue strain, and that utilizes the best of nature's gifts, then will we find that contentment in life will follow and that insanity in many forms will materially decrease.

Then, and not till then, can it be said that the physician has met this great responsibility wisely and that he has done his whole duty to the millions of suffering children who stand about him trembling under their grievous burdens, mutely appealing to him for relief.

DISCUSSION.

A

DR. JOHN L. TURNER, Terrell: I have had occasion to observe the results that Dr. Lankford has been talking to you about. It is very common with superintendents of insane asylums to find just such cases. young lady, for instance, who comes into the institution in a high state of excitement-we very often find that she has been pushed through school studies in addition to music and accomplishments. In other words, she has been over-burdened in her tender years, when she should have been making muscle and tissue, and the brain should have been developed, not along educational lines, but along anatomical and physiological lines. In after years all these other things could be attended to. The paper was a very good one, and dealt with matters to which we should give more attention. Our institutions are becoming more and more crowded with patients of this kind, and the time is fast approaching when we will have to deal with the question in a very positive way.

DR. JOHN R. BROWN, Hutto: Dr. Lankford has sounded a note of warning in no uncertain tone. I have been teaching myself in so-called higher institutions for a number of years, and have had ample opportunity to verify what the doctor has said. There is one line of cramming that is particularly pernicious, and that is the line of music. Music is considered a kind of play, but it is play which is particularly debilitating to the growing mind. Those of you who are familiar with Tolstoi's Kreutzer Sonata know that the subject we are talking about is illustrated in it. There we have the effects of a strong stimulus to mental exertion carried

to excess. I know of many cases which have got into asylums through too much application to music in early years-about the age of puberty. It is the apt pupil, too, who suffers most. A reform is necessary. That is clear, and if some of the frills of education could be lopped off and a more symmetrical education substituted-one that would train the pupil's powers of observation instead of cramming his or her young mind with facts that fade away like the summer's dew, we would have a healthier race and fewer of the cases of which we have been speaking. In the northern State of Minnesota the foremost educational people have waked up to a realization of the existing state of things. They have come to understand that education means an upbuilding-not a system of cramming and ruining the child's mind. Medical supervision over schools such as prevails in Chicago is also required to see that the sanitary conditions of the school rooms are satisfactory, and to see that weak and delicate children are not overtaxed. Most of us would only be too willing to assist in such work if requested to do so.

DR. R. H. RUSH, De Leon: I agree with all that has been said as to the evil effects of overwork of the kind indicated on growing minds; but there is another thing—and I am afraid it is a growing habit in this country-which brings untold misery on the human family. I refer to the use of narcotics. That is one of the things that is most apt to bring on insanity. I have had occasion to make some observations along this line. In a great many instances of children suffering from nervous headaches and a generally over-strained nervous system, it will be found that their trouble is largely due to the use of headache and analgesic powders and tablets, all of which contain opiates. The first thing the mother does when the child has a headache or is nervous is to give it one of those powders or tablets. In many instances the doctor has to ask what has been given the child, and he finds that it is one of the narcotics. Medical men owe a duty to their profession, to their patients, to the country, and to the unborn in connection with this matter. They ought to give warning through the newspapers and otherwise of the injurious effects of this habit. I do not think that this particular point can be overdrawn when we consider the immensity of its power for evil, and the actual harm that is being done by its means to the rising generation.

DR. LANKFORD, in closing, said: I have only to reiterate that I consider the matter as one of extreme importance, and that I think it would be of the greatest importance if every member of the Association were to look into the condition of the schools in his neighborhood. I thank the gentlemen for the discussion.

24-Trans.

THE PHYSICIAN AS AN EXPERT WITNESS.

R. B. SELLERS, M. D.,

SAN ANTONIO, TEXAS.

Owing to the contradictory testimony of the medical experts in the celebrated Rice case, which has recently attracted such attention, I deem it justifiable to give my views in a short paper on the physician as an expert witness.

Very much has been written during the last decade on this class of testimony, especially by the legal fraternity, and in most instances their views were condemnatory of our profession when we were called to the witness chair as an expert.

Why such views should be entertained is readily seen when we read the court proceedings, both in England and America, in which the testimony of physicians acting as experts differ so materially as to cause the witness to be subjected to gross indignities by the opposing counsel during a vigorous cross-examination, and be ridiculed before the entire court.

The question naturally arises: Why is this difference and is there a remedy?

Medicine is a science, and those of us who are students should be familiar enough with it to give before the courts such information as is deemed proper, and in a professional way, without differing materially in our opinions of scientific facts.

To clearly understand what an expert witness is, we refer to the Century Dictionary and Encyclopedia, which says it is "a person who by virtue of special acquired knowledge or experience on a subject presumably not within the knowledge of men generally may testify in a court of justice to matters of opinions thereon,-as distinguished from ordinary witnesses who testify only to facts."

The physician who testifies that he was in attendance on the case in question, that the patient was suffering from some special disease or injury, and that he had carried out certain treatments, he is not

an expert witness, because he states facts that have occurred; but where a physician is summoned by either plaintiff or defendant to give before the court his opinions or investigations in a certain case, or a hypothetical case, as to the results in question of either medicine, surgery or chemistry, he becomes an expert.

Before going further, it might be interesting to know some of the many instances in which a physician can be asked to qualify as an expert, as: First. That of sudden death. He must examine the body, be in attendance with the coroner during the autopsy; if cause of death be unknown, he must examine the heart for organic lesion; the stomach for poisons or gross pathological conditions; the brain, to see if death be due to hemorrhage; and the kidney, to learn if it was caused by renal disease. In case of an infant, to learn if death occurred before birth or by strangulation; if during a convulsion, was it caused by poisons administered, uremia, apoplexy, epilepsy or intoxicating drinks.

Second. The effect of wounds as he viewed the body, and whether such wounds were sufficient to cause death; or, if not dead, would they necessarily be fatal.

Third. In case of malpractice, as to whether the treatment used was proper, and what would have been the results had other methods been employed.

An interesting case, in which I was called as an expert, came up in our State a few years ago. The plaintiff, a criminal, jumped from a moving train and broke his leg. He was picked up, leg set in plaster, put back on train by sheriff and taken to the place of his crime the same day of his accident. The fracture failed to unite properly. After serving his sentence, he sued physician for malpractice and the sheriff for moving him, but failed to get judgment. Fourth. In cases of abortion, whether attempted or completed; if it was justifiable to save the mother, or if it was criminal.

Fifth. In cases of rape, after examination of the person, whether penetration had taken place, if hymen was ruptured or the genetalia bruised or torn.

Sixth. As to the use of the microscope, in differentiating certain diseases or conditions not recognizable otherwise.

Seventh. The examination of the blood, or if a stain be blood, and if human blood.

Upon this point experts have differed, some claiming that human blood can not be distinguished from that of some animals, as the dog, while others hold that the difference in the size and shape of the red blood corpuscle in man is distinctive.

Eighth. In insanity. The law in this State, as in several others, does not take the testimony of a non-expert except that of the family physician, as to the sanity or insanity of a person, though it may receive such testimony as to the actions of the person in question. See Gehrk vs. State, 13th Texas Reports, 568; Hickman vs. State, 38th Texas Reports, 191.

An important point under this head is the testimony of the expert as to the sanity or insanity of the person where his mental condition is questioned in the signing of his will. Such evidence in testamentary cases should call for the greatest caution and concern, and should only be given by alienists of pronounced standing, after a careful examination of the person in question, for often the changing of much property depends on their testimony as to whether the person was capable of making a will at that time, or if the aberration came on after the will was made.

Knowing, then, some of the points in medical science on which we may be called to testify, we ask what should be required to qualify as an expert?

In the first place, he should be a reputable physician. He should be a graduate from a recognized school of medicine. He should be a man of integrity. He should be known as a man of ability in his profession in the town or city wherein he resides. He should have made a special study of that particular branch of medical science which is called in question in that individual case; in other words, he should not be called in a surgical case unless he has more than a general knowledge of surgery, nor in a case requiring a chemical analysis unless he be a chemist; nor to pass on the sanity or insanity of a person unless he has made a special study of mental diseases. He should go to the witness chair as a man of science and truth, and his testimony should be impartial and exact,