In 1870 the man who was to become the first professor of orthopaedic surgery in the United States, Lewis A Sayre (1820-1900), was sued by the parents of Margaret Walsh, a little girl on whom he operated in 1868. He published at his own expense the proceedings of the trial, which vindicated him, under the title The Alleged Malpractice Suit of Walsh v Sayre.

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Samuel Gross, professor of surgery at the Jefferson Medical College and the subject of Thomas Eakins’s great painting of Gross operating, The Gross Clinic, wrote a congratulatory preface to Sayre’s transcript of the trial…: “Some members of the American bar are, unfortunately, too prone, for the sake of a paltry fee, to encourage and engage in such prosecutions.”

I am glad to say, however, that not everything has remained the same: the fees are no longer paltry.