false and degrading position. They find that their cunning subservience to the false opinions of the people, has increased the hold of those opinions upon the public mind; and, as a wide door has thus been opened for quackery, they find that the same arts, in using which they have been so successful, are now used quite as dexterously by the whole herd of ignorant quacks and showy pretenders. They find that the Homœopathist is stealing away some of their best, and, as they thought, their most reliable patients. And of this they have no right to complain, because these pretenders obtain these patients by the same artful and deceptive means, by which these Physicians at first acquired them, and by which they have so long retained them among their patrons.

The result which I have pointed out is an accumulated result. The community are running wild now after various systems and modes of practice, and the public mind is all afloat, carried about by every wind of doctrine in medicine. It is now the hey-day of quackery of all kinds and degrees. The causes of the great prevalence of this evil are not temporary and recent, but they have been acting for a long time, and we now see the accumulated result. Among the chief of these causes is the course which has been pursued by a large portion of the medical profession. The profession itself has given birth to much of the quackery of the present day.

The evil of this comes upon the profession generally, but more particularly and grievously upon the class of Physicians of which I have just been speaking. The first class which I mentioned are not as much affected, because, being less scrupulous, they have a wider range of arts to be used; and the mortifications to which they are subjected in their competition with quacks more easily borne, because they have less of honour and conscience to trouble them in relation to their course. While this class will be utterly opposed to any attempts at reform, the second class of which I have spoken, seeing their false position, and beginning to suffer some of its vexatious results, will probably experience a sifting process, whenever efforts at reform shall be thoroughly entered upon. The least honourable, and those whose habits of imposition (for such they must be termed) have become fixed, will join the first class, giving up all scruple, and adopting in full the measures of the quack and the charlatan. But I am persuaded, that the largest portion of this class of practitioners have so much of honour and conscience, that, whenever a general effort shall be made to redeem the profession from its false position before the community, they will be ready to unite in that effort.

But this effort is not to begin in this class. There is still another class of Physicians who are to originate it. They are the men in our profession who have always pursued an honourable course, and have never

yielded to the temptations to use the arts of empiricism, however strong they may have been-who, though they have often seen their brethren use such arts successfully in their competition with them, without injuring their standing in the community, have never allowed such mortifications to induce them to swerve from the path of honour and duty. Efforts, it is true, have been made by such Physicians to enlighten the public mind in relation to its false estimates of professional merit; but they have been, for the most part, isolated and individual efforts, and they have soon been given up, for reasons to which I have before alluded. A general and united effort is needed to prove successful.

CHAPTER VIII.

INTERCOURSE OF PHYSICIANS.

THE object of this chapter is to introduce some points in relation to the intercourse of Physicians, which the community ought to understand, and to endeavour to correct some prevalent errors, which tend to destroy the harmony of the profession and to impair its usefulness. Mistaken notions are very prevalent even among thinking and judicious men, both in regard to the object of consultations, and the principles by which they should be regulated. These notions sometimes exert a very injurious influence, and the patient is deprived of the benefit to which he has a right, from the combined wisdom of those who consult upon his case.

What then is the main object of a consultation? is an important inquiry. It is considered by many as the chief object of a consultation to decide the question,

It is an error

whether the patient will die or recover. to suppose that the decision of this question is the principal object of the consultation. Frequently nothing like a decision of this question can be arrived at. Farther developments in the progress of the case must be waited for before a prognosis can be justly formed.

Neither is it the object of a consultation to have the Physician, who is called in, prescribe to the attending practitioner what he shall do, though this is often considered to be the object, especially when the consulting Physician is much older. Dictation is very far removed from consultation.

Again, it should not be among the objects of the friends of the sick, in calling a consultation to obtain the opinion of a Physician upon the course of treatment which has been pursued. He has nothing to do with the past, except so far as it will avail him in discovering the true nature of the case, and in fixing upon the course to be adopted at the present time. He steps out of his province, if he says anything to the friends in regard to what has been done. The rule applies not only to criticisms upon practice, but to all expressions of approbation also. The patronising air with which some Physicians utter their commendations of the course which has been pursued by the attending practitioner, is a most flagrant insult. It generally involves

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