upon as far as he deems it best to make it known. There is one rule as inflexible as the laws of the Medes and Persians that must be obeyed by all physicians, at almost any hazard or trouble, and that is punctuality in consultation visits. A doctor of ability great enough to be called on for aid in such a case is a man usually in busy practice and time too valuable to waste in waiting. You have rights also, and he being delayed you may consider the consultation. postponed to a more convenient season; or you failing him, if he is unable to come again readily, he examines the patient, writes out and seals his opinion and leaves it for your visit. However, the fates being propitious and the parties being assembled, the physician in charge gives his statement of the case and opinion of the treatment. The others then follow suit and agree with him (if it suits them), in which case he is considered a trump, and having taken their opinions may "follow their lead or go it alone" in the future care of the patient regardless of them if the exigencies of the case call for different treatment than that agreed upon. But the reasons for such change must be stated at the next consultation (should the patient survive long enough to require another meeting). This is also the privilege of the consulting physician if called in to act, the regular attendant being present. If holding a consultation it is well not to introduce theoretical discussions, for they lead to much loss of time and may be of temper.

For instance, a Matador holding a seance with a bull waves a red flag, and immediately there is a rupture in the friendly relations previously existing. Holding the illustration in view, then, a homoeopath consulting with an allopath should not provoke discussion on similia vs. contraria, or a high potency man commence waving the red flag of a disquisition on the merits of his views and the demerits of his compatriot's low potency prescriptions, for thereby cometh not good. The time and place for such discussions is elsewhere, and you meet for agreement

in the case in hand and modes of practice hallowed by experience and observation. However, if there should be such a diversity of opinion that no satisfactory treatment can be adopted, the patient being the interested party may select the physician in whom he places the most confidence, and the other conscious of his own rectitude retires with all the politeness and suavity of manner he may be able to command under such trying circumstances. But following this, should the patient have decided to his own disadvantage and the result prove fatal, while it may not be in human nature to entirely omit a mental congratulation of oneself on his perspicacity and a thought that "I told you so" flash through his mind, the thought should be kept in perpetual imprisonment and not even allowed to peer through its prison bars in a gleam of triumph as our rival meets our eye. Per contra, should the case recover and your prognostication of evil fail of fulfillment, do not consider this a breach of etiquette, for this method of giving the lie is quite the correct thing after all as viewed from their standpoint.

The physician who is called in counsel is placed. upon his honor in his attendance in the case, and should entertain the most scrupulous regard for the character and standing of the family practitioner. There are many methods that may be and are often adopted of lessening the confidence reposed in him. Ways and means that are so indefinite that no exception-in words-can be taken to them.

"The shrug, the hum, the ha, these pretty brands that calumny doth use," or with look of doubt or disapproval that may convey worlds of meaning to a patient and the anxious friends.

Absorbing it they may cry with Othello: "Thou criest, indeed; and didst contract and purse thy brows together as if thou hadst then shut up in thy brain some horrible conceit;" and as suspected but unknown dangers are always most frightful, so may such dishonest practices destroy the harmony of feel

ing and rupture the bond of implicit trust so necessary to the comfort of the physician and patient.

A Method of Increasing Practice.

Should there be good reason for dissatisfaction with the previous treatment labor with the erring brother in secret and not openly; change his practice by private exhortations and avoid public denunciation. A prolific source of contention among our fraternity is the too great anxiety to increase a practice at the expense and detriment of a neighbor. It requires a certain amount of moral courage when called in to see another physician's patient, the said patient being blessed with a long and well-filled purse, it requires, I say, a deal of moral integrity to act as though you were the other doctor, and working entirely for his interests, and there is a strong inclination pulling at you in that tender spot, the pocket, to send the absent doctor's interest to the evil one and make hay for yourself while the sun shines down on your chance. Dixon's Medical Fox discourses as follows on this subject: "I stuck it out till I got nearly starved, and my coat looked as though it had been between the jaws of a hungry wolf, till one day it all at once occurred to me that I had been a great ass. I had all along had a notion that the 'Code of Ethics' my benevolent seniors had prepared for my guidance when they let me go out of their trap was a one-sided sort of an affair. In it I was instructed to keep close to my hole and only to look out with great reverence when any of the old foxes passed by; meanwhile they never looked in to see if I had anything to eat. I used to hear a most attractive screaming in the neighboring poultry. yards every night, and was obliged to content myself with licking my chops till morning; when the cunning old fellows had hied to their holes, then I would crawl out and pick up a patient in the shape of a servant maid or an irishman. These were poor picking, however, for a cub who had been used to good feeding, and I was nearly in despair.

One day, however, I was summoned to visit a rich old turkey of city, who lived near my hole in Bleecker street, and who was suffering with a "foie gras," the result of good feeding. I licked my chops in anticipation of a glorious fee; and after smoothing my old coat and making myself look as innocent as possible I presented myself at my neighbor's elegant mansion. I was forthwith walked upstairs to the old turkey's roost, when he coldly informed me that he had only sent for me to give my opinion, as one of the old foxes was his family physician, and he had every confidence in him till day before yesterday, when he positively forbade his eating turtle soup. As he had never forbidden him anything before, and always bled and purged him every fortnight for his headache, with the best results, he naturally concluded something was wrong and the doctor was getting crazy with some new-fangled notion or other. My new-fledged hopes were dashed at once to the earth. Here was an admirable chance for a capital bill; bleeding and a prescription XX and XX Jalap and Calomel every fortnight and the extra visits for all the uncomfortable gripings, et cetera.

What could I, what ought I to do with such a fat turkey before my very jaws, and the old goose of a professor having absolutely frightened him into a doubt of his abilities? (And with what reason?) Was it in the nature of a medical cub to resist? Yet the Code of Ethics forbade me opening my jaws to nab my fat friend. How wisely have they ordained it (for themselves) that we shall not open our lips to contradict any of their absurdities unless they are present. My hunger made me desperate. I determined to strike for freedom and turtle soup. I not only told him that his attendant was mistaken, but that a strong natural want was instinctive demand and must be obeyed; turtle soup I continued was admirably adapted to his constitution, and he should have it immediately. I felt his pulse, and passing my fingers over the bend in the arm I remarked that

he had been repeatedly bled, no doubt with excellent effect, but in fearful proximity to the artery, drawing in my breath at the same time convulsively, as I had observed my preceptor when strongly interested in a rich patient's narrating his case and disapproving of his predecessor's prescriptions.

My ruse took beautifully. The old cock was thoroughly frightened and the very wattle around his beak, though dyed with the best Oporto, turned pale, and I thought he would have fallen from his perch. I seized a bottle from which he had been imbibing and let him have half a tumbler good. While he was in the swoon I took as much myself, and as soon as he recovered I smoothed him down beautifully. I told him to tell the old fellow that attended him he was a fool and would kill him outright if he deprived him of his soup; that he was nearly blind and couldn't bleed him with safety. Then I fired my 12-inch mortar to clinch him. I told him that arterial varix had been the frequent consequence of such ignorant butchery. In short, I spoke with such pathos and feeling that with that and the port and the fear that he would not send for me again the tears came into my eyes when I shook hands with him as I was about to leave. I felt in my very soul I had done perfectly right. I always believed my preceptors to be great rascals, and I never could discover why a young fox shouldn't eat turkey as well as an old one. I am sure I never could tell why a poor devil of a patient should be deprived of two separate and independent opinions respecting his precious carcass, as well as two legal ones about the title of an estate. Indeed I think he is much more likely to require them, as doctors are an accommodating set and will give them pretty much what they seem to desire, and so they get confused when they come to think it over. My patient assured me he would keep my visit a profound secret; but I told him I did not care a farthing; he might tell the old ass as soon as he pleased, and I would like to be there to hear him bray. It was natural that I should