I had to proceed at lightning pace, under tremendous difficulties, with no assistance at all when I ought really to have had two people, another doctor and a nurse, in order to get the operation completed before the patient began to move on recovering her senses. I was obliged to be swift and skilful and strong-physical and mentally. My patient fortunately survived. For this and ten days' attendance, 30/-!

Such are the feats that general practitioners commonly perform, and hardly ever get paid well enough for them. Doctors are saving the lives every day of a people who allow that their bills shall be the last of all to be paid, who complain that doctor's fees are high when-if they only dare honestly confess it-more than half the doctors in the land have difficulty to make both ends meet. Only the other day I saw in a daily paper the case of a doctor suing a patient for fees-a rare thing for a doctor to do. The patient complained that 3/6 was too large a fee to pay a doctor each time, for visiting and medicine. The magistrate elicited the fact from the doctor that he could hardly make a decent professional man's living even charging such a fee, and he was the only doctor practising for some distance round. What lawyer would drive to the house of a client, in order to elicit in a half-hour's visit a good deal of information, and finally to write a letter-all for 3/6? There are many doctors in the East End of London who will visit a house and provide medicine for 1/-, others who will give advice and medicine at dispensaries for 6d. !—nay, some even for 4d.! But this sort of practice is well-paid compared with contract work, which necessitates a degree of professional "sweating" that is infinitely more degrading, in proportion, than any other form of contract "sweating" amongst the lower classes. Tens of thousands of families in Great Britain are attended by properly qualified and educated medical men for 3d. a week. For this sum (minus the commission for collection) these medical men engage to attend the whole family and provide

the necessary medicines, dressings, &c. A well-known authority writes, regarding this state of affairs:

"Personally I hold that it is bad for the patient, and demoralising for the doctor, but whatever one's views may be on the principle, it will not be necessary to point out to medical readers that proper attendance cannot fairly be given for the sum of 3d. a week to a household which may be averaged at four persons. One of two things is, it seems to me, bound to happen. Either the doctor will make his attendance and drugs fit in with the price, in which case the patient is inadequately attended, or if he conscientiously does his work he is "sweated" by his patients. Either alternative is unpleasant to men who take any pride in their work or who have any self-respect."

CHAPTER IX

THE MAKING OF A MEDICAL PRACTITIONER

WHETHER he be one of the great general public or a doctor himself, the reader may for the first time, after being introduced to several different kinds of medical men in former chapters, all aiming at the goal of professional success, perceive how much the designation medical practitioner, indicating to the laity some sort of uniformity, may fail to convey an adequate idea, or to suggest any possible extreme variations, of the real human character. "Doctors so often differ," is a remark commonly made when the differences of opinion of doctors are discussed; but are doctors not likely to differ in opinion when constituted of very variable material?

How is it that amongst the very large number of youths who commence to study for medicine so few reach the goal of requisite qualification or degree? What is it that makes "wasters" and "failures" of so many medical students? Many would answer that there will be chaff as well as wheat in every society or community, and that there could be no help for it. But I must give you my own opinion, however, that the life led by medical students could be made much more conducive to uniformly good results than are obtained at present. Parents chiefly think of the expense of this or that place of study when deciding where their son shall go, but what is the use of such a reckoning when the conditions of life are such as militate against the desirable progress of the student?

I consider that the question of social and domestic life is a far more important one for parents to consider than the suitability of certain schools for gaining knowledge with a view to passing examinations. Some Englishmen may advocate the London schools of medicine as against the Scottish, for turning out good men, while an Edinburgh set will pride themselves in the knowledge that a great many of the best living and dead medical men are, and were, Edinburghtrained men. The fact is that every recognised school is capable of producing good men, and all of them can fit candidates for any examinations there are, if the candidates themselves are capable enough. But the social and domestic life a man is likely to lead in one place or the other is a matter of the highest importance. How can satisfactory examination results be obtained, anywhere, if a student be led to "wasting," or perhaps drinking and gambling?

No; parents should not first look forward to seeing learned letters after their son's name, as well as frock coats and fine carriages in their equipment, without thinking what gauntlets the son will have to pass through before he reach these. Parents should consider the social and domestic amenities their sons are likely to be cast amongst, as students, if they are in earnest about them. The work is very hard before a man can obtain a qualification in medicine. And very often the freedom of the individual is absolute, such as when he arrives either in London or Edinburgh with a bag of money for the term's or session's expenses, and proceeds to look for apartments, almost as free as an enterprising pioneer going "up country" would be in Africa. As often as not he is in the position of neither knowing nor caring for anybody. He cannot have a guardian to accompany him; he must get on as well as he can under the circumstances.

There are some who are fortunate enough to have their parents living near to a good school of medicine. In such a

case their social and domestic life will be everything that could be desired, as long as they can have proper opportunities for home study. Others are able to live with distant relatives near some medical school. A very large number of medical students, however, leave their homes many miles away to live in lodgings near the medical school of their parents' choice, not only absolutely free to do anything they may wish, but entering a domestic life that positively conduces to irregular habits. I state frankly that I should not care what medical school my son went to, or what degrees or diplomas he might try to obtain, as long as I knew that he was domestically comfortable and happy, and as long as nothing hindered him from feeling naturally disposed to take more interest in the work of his profession than in wasting and wantonness. number of youths who commence to study medicine and who rapidly go to the bad is appalling, and this is chiefly due to the fact that they are suddenly cast into vortices of mixed pleasure, having no restraints and no inducements to walk on straight paths beyond what their own sense or want of it— instructs them. And everyone knows what free-absolutely free-young men's tendencies are in very many instances. They are scarcely human if they can keep quite straight under the average temptations of a medical student's life. One would not grow serious over slight lapses, which are soon recovered from, and which, after all, give experience; but little things tend to greater, and greater things to hopelessness, in so many instances; that is the worst of it. When I think of some capital fellows, with many good qualities, who were once college fellows of mine, and concerning whom I am now afraid to know the truth-when I realise that they would some of them now be pleased to clean my boots for a drink and a cigar-then I feel that I am not wasting this paper I write upon.

There are some men, I know, who would go wrong any.