ter with gelatinous tissue surrounding and denser structure at periphery. The patient died seven months later, the mass having advanced into the lumbar region. Coley's serum was used after the operation.

Aside from my direct interest in this case the opinions of three very prominent pathologists, to whom sections of the testicle were sent as to the microscopical findings, were very interesting to me. Pathologists as well as clinicians disagree. One said the diagnosis was carcinoma, another that the specimen was indicative of syphilis, while the third stated that the slides revealed an infected large round celled sarcoma.

that the testicle had been malignant. As the diagnosis could not be positive he insisted on operation, trusting some other condition less serious might be present. The operation confirmed the diagnosis. Inoperable sarcoma was found and incision closed. Patient died shortly after.

My purpose in this paper is to protest against any lackadaisical policy in the diagnosis of enlargements of the testicle. Any aesthetic reasoning of the patient directed toward the maintenance of the organ on a watchful expectancy basis should be discountenanced if there be any question of malignant change.

year.

In giving you an account of my stewardship, I am pleased to report that the year has been a successful one in every way and respectfully refer you to the reports of our worthy secretary and treasurer. I assume only a small part of the credit for this. It belongs largely to the indefatiguable work of our secretary and the hearty co-opera

corre

tion of the members; all working in harmony and unison.

Besides the scientific work accomplished during the year, I am pleased to state that a great deal has been attained in a social or fraternal way, cementing a closer bond of fellowship which should always exist between physicians. Every physician is benefited by writing or listening to papers on medical topics by his confreres and joining in the discussion. Yet, the social intercourse brought about by their meeting together is of no less value.

Truly, we are reminded that there is

Two hundred miles east of the ruins of Babylon are the remains of Susa (or Shusan) the ancient capitol of Elam. Among the ruins of the Acropolis of Susa, in fragments easily reunited, De Morgan, the French archaeologist, in December, 1910, and January, 1902, found the long-lost Code of Hammurabi, who was King of Babylonia from about 2240 to 2135 B.C. Hammurabi was a conqueror and empire builder. From the great number of tablets containing deeds, wills, bills of sale and the like that have been found of this period the social life of the time is rather inti

mately known. The people were edueated, deeply religious and humane. Their laws and usages were more in accord with the civilization of our day than were those of medieval Europe.

Considering the insecurity of life and property and the generally prevailing ignorance of our Christian middle ages, it is surprising to find that three thousand years before those days agriculture and commerce thrived in the teeming valleys of Euphrates and Tigris and that various branches of mathematics, geometry and particularly astronomy, had developed to a marvelous extent. That Hammurabi had promulgated a great Code of laws was known to archaeologists long before the discovery of the Code itself. Many clay tablets containing reference to one or more sections of the Code had been laboriously deciphered.

While Hammurabi's fame as a wise and righteous law-giver cannot be gainsaid, yet his Code was mainly a compilation of existing laws, some of which had doubtless been in effect, in part of

the state at least, for centuries. Indeed from references in certain tablets, that antedate Hammurabi's Code by hundreds of years, there is considerable reason for assuming the existence of a very much earlier Sumerian Code that may go back to three or four thousand years before the birth of Christ.

In its way the Code of Hammurabi was as important to the civilized world of his day as was the Code of Justinian to the Roman world of nearly twentyeight hundred years later. When we consider that this Code was written two hundred years before Abraham's time, we are astonished at the marvelous development of society in that remote age. Laws on the riparian rights, master and servant, domestic relations, torts and most of the things treated in our own Codes prove that these people were little behind the civ ilization of this day. This Code strikingly resembles the Mosaic Code which was of much later date. "Eye for eye, tooth for tooth," of the Mosaic law, as given in Exodus, are literally provided for in the Code of Hammurabi for injuries to patricians. Such to plebeians and servants could be settled by a money fine.

Of particular interest to physicians and surgeons are certain sections of the Code. Much that has been written of the medical knowledge of the ancients is erroneous and a great deal based on evidence that is altogether insufficient. That which we get from the Code, however, may be relied upon as far as it goes. There is no doubt that the materia medica of the Babylonians was very extensive. Their medical treatises covered all sorts of affections. Their physicians used roots and oils and many powdered drugs. They also associated diseases with demons and used charms.

The following sections of Hammurabi's Code is from the translation of C. H. W. Johns, in his work, "Babylonian and Assyrian Laws, Contracts and Letters."

Section 215 says: "If a surgeon has operated with the bronze lancet on a patrician for a serious injury and has cured him, or has removed with a bronze lancet a cataract for a patrician, and has cured his eye, he shall take ten shekels of silver."

No. 216: "If it be a plebeian, he shall take five shekels of silver."

No. 217: "If it be a man's slave, the owner of the slave shall give two shekels of silver to the surgeon.'

It is of especial interest to us at this time to note that forty-two hundred years ago the law recognized the justice of grading fees in accordance with the means of the person treated. Also, that it stipulated the fees to be paid. Our legislators have evidently just caught up in the passage of the Medical Insurance Act. It is to be hoped, however, that in the goodness of their souls they will not further emulate our old friend Hammurabi and demand of the surgeon "eye for eye," as he did. We read further

No. 218: "If a surgeon has operated with a bronze lancet on a patrician for a serious injury and has caused his death, or has removed a cataract for a patrician, with a bronze lancet and has made him lose his eye, his hands shall be cut off."

No. 219: "If the surgeon has treated a serious injury of a plebeian's slave, with a bronze lancet, and has caused his death, he shall render slave for slave."

No. 220: "If he has removed a cataract with a bronze lancet, and made the slave lose his eye, he shall pay half his value."

It is seen that operations on patricians involved many undesirable features. I am sorry to say that our advanced surgical methods of today have not reached that degree of perfection. to enable the surgeon to attempt many operations under such penalties. Possibly this was Hammurabi's method of checking an undue fondness for opera

tions on the part of Babylonian surgeons.

Veterinary surgeons also thrived in those days, but came in for their share or responsibility, as the following quotations from Hammurabi's Code testify.

No. 224: "If a veterinary surgeon has treated an ox, or an ass, for severe injury, and cured it, the owner of the ox, or the ass, shall pay the surgeon one-sixth of a shekel of silver, as his fee."

No. 225: "If he has treated an ox,

or an ass, for a severe injury, and caused it to die, he shall pay one-quarter of its value to the owner of the ox, or the ass.

The value of a shekel at that time was equal to about thirty cents of our money. For an operation on a patrician a surgeon received about three dollars, then again he might lose his hands. For an operation on an ordinary assnot a patrician-the veterinary could collect five cents, if he cured him. Such fees seem insignificant to us, but not so at that time, as the average wage, for a laborer, was one cent a day.

New Babylonian and Assyrian records are constantly being discovered and many already unearthed are still undeciphered. As these translations progress, doubtless much curious information regarding the ancient practice of medicine will come to light. While it is improbable, it is still possible, that some information may be found that will be of value to the twentieth century physician.

Bible history is not at all complimentary to the physician. Only one reference to the physician and patient is found. Chronicles, 17th chapter, 12th and 13th, say, "And Asa, in the thirtyninth year of his reign, was diseased in his feet, until his disease was exceedingly great; yet in his disease he sought not the Lord, but to the physician. And Asa slept with his fathers and died in the one and fortieth year of his reign."