be any is this: You will tell him that he is tubercular but not consumptive, that he is not going to die, that he may become consumptive if he should get worse; that many, indeed most people like him have a good opportunity to get well, that it is a common experience to find people die of all sorts of diseases at 60, or 80, in whose lungs there are tubercles healed, that indeed there are comparatively few persons who have no tuberculosis some time in their lives; that he can save himself, and protect his family with a moderate amount of care and foresight. You may do that, and it is true. You tell him truthfully that he has tuberculosis and that it is his duty to get well. What you will not do is what I experience several times a week. A poor patient tells you his doctor has told him he has consumption, and unless he goes to Colorado at once he will die. Imagine a poor person, very often with a wife and children, with no money to pay even his railroad fare, much less to live, told in just so many words that he cannot be helped. There is much ignorance and thoughtlessness and cruelty in the intercourse of men, but I know of no act of brutality that equals this treatment of poverty and maladystriken persons on the part of members of our own profession. There is no reason to indulge in it in your relations to the sick. If you have the cruelty of your convictions, try it on the rich who are independent of you, but neither on the poor in private life nor on hospital patients.

Never, my young friends, give up watching a case as long as you are in charge. Most cases of disease have a tendeney to get well; that does not mean, however, that they should be left to themselves; for the measure of strength saved from an illness determines the duration of convalescence, the restoration of the tissues and the future power of resistance. Many may recover unless they be neglected; if they do not so recover their blood is on your soul. Some will die no matter what you do and try; even then euthanasia is welcome if you cannot procure more; it is better than the anguish of the suffering of many that are

moribund. In many such conditions the question has been raised whether or not it might be permitted to shorten the life of a hopeless martyr who is in torture which must end in death. I was present when a minister of the gospel in my city rebuked us doctors roundly for not finishing the misery by a friendly poison. When I heard it, I remembered the little sentence in the Latin primer of my early childhood: Medae projiciebant moribundes canibus. The Medes threw the dying to the dogs. When we doctors shall become Medes we shall obey the ruling of that clergyman. Meanwhile we have sworn with Hippocrates: "I will give no deadly medicine to any one if asked, nor suggest any such counsel.”

In order to fulfill the indications required by the sick, the convalescent, or the dying, make yourself acquainted with the rules of nursing and dieting, and with the nature and effect of remedies both external and internal. When I was a young student, the medicine of Germany was just waking up from a forty years' slumber caused by the unintelligence of what was called naturephilosophy. At that time the Viennese learned pathological anatomy from the French. One of the greatest teachers of that branch was Rokitansky. For him all there was in medicine was the study of the dead body. For Skoda, however, all there was in medicine was diagnosis, mostly percussion and auscultation. For the patient all there was to do was to go to the hospital, to be diagnosticated by Skoda, and to be opened by Rokitansky. Medical science and the patient met only twice, once on the hard hospital bed, next on the autopsy table. He had done his full duty when the diagnosis and the result of the post-mortem examination would agree. Therapeutics there was none. The time of the big medicine bottles with the nauseating draught had gone by, thanks to Hahnemann; whatever was presented by Hahnemann however could not meet the approval of unsophisticated savants. So there were no drugs, no treatment. While formerly both medication and blood-letting had been overdone now every

thing was discarded. Dietl of Vienna, and Hammornjk of Prague founded that nihilism of the Vienna school that under the flag of so-called pure science has resulted in driving the patients into the camps of sectarians or quacks who after all would hold out a promise to the despairing.

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All that has changed; modern medicine has learned its responsibility to the individual patient and to the community. We have entered upon a new era, that of therapy; both the individual and the community are recognized as claimants upon our bounty. Gentlemen, you are not alone in the world, nor in the profession. You could not live a hermit in the midst of millions, away from the village, county, State, nation and the universe. A hundred ties bind you, to benefit, and be benefited by, the rest. So you are bound up with the profession, from the first day you enter it. I advise you to join one or more societies at once, all events your County Society, or any other that commends itself for its scientific work, or for its affiliation with the American Medical Association. The complaint we often hear that there are too many medical societies, may be justified as far as large cities are concerned, but there should be enough of them all over the country to give an opportunity to every practitioner to join at least one. The benefit to all its members is mutual. As there is a political, so there is a professional citizenship, meant to improve the individual, increase his knowledge, compare experience, adjust mistakes, and learn modesty. We were not made to be alone, capsulation kills the efficacy of trichinae, bacilli, and men equally, and the interests of a profession or a political commonwealth are not safe unless in the application of a universal democratic spirit. Nor can great results be obtained except by the altruistic co-operation of many. Legislators have been aware of that more thoroughly a century ago than at present. At that time they were always willing and anxious to endow the medical profession with such legal rights and privileges as would enable it to look after the interests of public health and

sound legislation. Even the authorization to practice was left to their judgement. Nor has the profession ever to my knowledge misused the confidence placed in it. The Sanitary Commission of the Civil War which has become a model for the world's imitation and the spiritual mother of the Red Cross, was controlled by the spirit of eminent doctors such as Cornelius R. Agnew and Ernst Krackowizer. The fight against epidemic diseases, which, as Virchow expresses it, should teach a statesman that when they exist they are a preventable or curable disorder in the social and political organism, has always been taken up by the medical men. Unfortunately, however, it is too often true, what Anacharsis said of Athens, that the wise men do the talking and others the acting. A few weeks ago, Gorgas and Reed and Panama formed no exceptions. A number of years ago we spent a million a day on a war of our making while a mere quarter of a million was refused that was to be spent on an instruction camp and lifesaving station. With what we spend in half a year to keep the survivors of a foreign population in subjection, we could eradicate tuberculosis from the United States within a generation. The battles against disease, prejudice, shortsightedness and incompetence are always fought by the medical profession, sometimes in a single combat, more effectually, however, by consolidation and co-operation. To this profession you have dedicated yourself. Be sure, my friends, that its practice be not a trade for you, but a vocation and sacred calling.

Many of you will enter the practice of medicine within a reasonable time. When your medical neighbor has patients while you are still waiting, never grudge him his own, and wait. When the first one has turned up, never feel that you own him. When your neighbor is well spoken of, do not believe that your reputation suffers when he is eulogized, and watch your shoulder lest it shrug. It is better that patients should seek you, than that you be running after them. Do all you can, and all your medical friends can teach you, and the books you have reason to

believe in. Do not despise after your graduation a good textbook, I consult them to-day (aye, even my own), for on a page or two some of them may contain the ripe experience of a generation; indeed not every text-book is compounded by a young man at the beginning of what he means to become a brilliant career. In the commencement of your practice, and later on for that matter if time permit be sure to read up in reference to every case under your care, and take exact histories. Never believe you know all about it, or enough for I assure you you don't. At least I don't, though I have studied medicine nearly sixty years. When a patient leaves you for some other doctor, it depends on your temperament, or vanity or needs whether you feel chagrined; do not blame the doctor who is called in your place. On the other hand when another doctor robs you of your patient by hook or by crook they say such things do happen - be sorry for that doctor, and for the profession he should not belong to, and be glad you are not the other man, but a gentleman. Remember that a gentleman finds it easy to compete honestly; when you are not treated that way, it worries but you are the gentleman, and people will find you out. competition on the part of others kindly, shows disregard for the rights of others, either doctors or patients, and bad citizenship, and exhibits jealousy, avidity and senility of the young or old

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Unfortunately we are not all angels. Indeed there was a time not very far distant when the facility of obtaining a diploma and the license to practice so filled the profession with undesirable men and women as to crowd the ideal as to what a physician should be to the wall. It is only with the growing difficulty of matriculation and increasing severity of examinations, particularly also the establishment of State License Boards, that the number of underweight doctors has become smaller. Their large number and consecutive competition rendered, as it does in any trade or vocation, the obtaining of a livelihood more difficult, and