Prior to the early 1800's, medical malpractice was almost unknown in the United States. However, a large number of malpractice law suits inundated the courts between 1835 and 1865. About 70 to 90 percent of the litigation involved fractures and dislocations with imperfect results or deformities such as shortened or crooked limbs. Lawyers alleged that the physicians did not provide due proper care, skill and diligence despite the fact that the better surgeons tried to save limbs rather than follow the common practice of amputation, especially for compound fractures. While a number of texts dealt with medical jurisprudence, it was not until 1860 that a text on the subject intensively delved into the issue of medical malpractice. Coincidentally, the attitudes and behaviors of patients, lawyers, physicians and judges during the first medical malpractice crisis were surprisingly similar to those currently held.