On May 8, 1923, Hornsby suffered an injury to his left knee in a game against the Phillies when he turned to make a throw. He returned 10 days later, but the injury lingered, and he was removed from a game against the Pirates on May 26 to be examined by Robert Hyland, the Cardinals' physician. Hyland had Hornsby's knee placed in a cast for two weeks, after which he returned to the Cardinals. During a game in August, Hornsby was on third base late in the game and threw up his hands in disgust in response to a sign flashed by Rickey; he had given the current batter the take sign, and Hornsby felt the batter should have hit the ball. After the game, he and Rickey fought in the clubhouse, but teammates quickly broke it up. Hornsby missed several games late in the year with injuries that the Cardinals (and Hyland) did not believe to be serious; as a result he was fined $500 ($ today) and suspended for the last five games of the year. However, Hornsby still won his fourth consecutive NL batting title with a batting average of .384. He also repeated as the leader in on-base percentage (.459) and slugging percentage (.627).