in practice, if you are grey or bald you need not necessarily be clever to be successful: this is the argument. A student recently remarked to me that he thought twenty-five years of age rather old for becoming qualified. "The older the better," I replied. "You will do very little good to yourself before you are thirty, if you enter into a purchased private practice." I repeat it, that to feel able, and even to be able, to prove one's capabilities, and at the same time to be prevented from advancing in practice simply on account of age or appearance, is disappointing in the extreme, and may lead to utter despair. I make a point of referring to the drawback of a youthful appearance, because I know there are so many excellent men who do not bear this in mind when first taking their diplomas, and who jump rapidly and rashly into some kind of practice on their own account only to fail in it. I have known some of the cleverest men to be turned politely away from houses they have professionally visited on behalf of their senior partner, because they have looked so young. But we cannot blame the almighty general public. People must have their own opinions, and must be guided by certain indications. All I need say further with certainty and freedom is, that any appearance of mature age-leaving alone scientific knowledge-helps very considerably to inspire confidence in a doctor.

As well as facial features, general personal appearance also inspires confidence to some extent. It is advantageous to look "every inch a doctor." Some will argue that professional men are not made by frock-coats and tile hats, but the fact remains that a doctor is more of a doctor, in the eyes and estimation of the public, if he dress as one.

Style, or manner, is also of the greatest importance, if a doctor wish to be believed in. It will be well understood by the reader that a man may suggest to an observer that he is either a surgeon or a butcher, according to the manner in

which he proceeds to roll up his sleeves and to brandish his knives; and the opinion of an on-looker will be further governed by personal appearance or by certain words uttered at the same time. It is not perhaps easy to explain it, but there is a doctor's style just as there is a clergyman's. Ordinary people refer to it and point it out, so it must be there. "I could tell he was a doctor by his style," one sometimes hears an observer remark. On another occasion, someone pointing out another practitioner will opine, "I should not have taken him for a doctor, judging from his style or manner.'

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The most powerful creator of confidence of all is reputation, of course. If a man be spoken of as possessing many and great abilities he will be sought after on this account alone, whether he be old or young, married or single-and, moreover, whether his abilities were real or spurious. Common reports concerning ability or knowledge are generally remarkably varied, however, about any medical practitioner, no matter how eminent he may be. Good opinions are rarely quite universal; practitioners are carried to success upon the wings of a majority of good opinions. There never was a doctor living who had no enemies! the best man in the world can find people who speak against him. Every doctor without exception threads his way through a mass of varied opinions, good and bad, and is successful or not according to which kind adhere to him in larger quantity. He may have any amount of tact: in earning good opinions he may at the same time adroitly avoid a good many bad ones, or he may be able to neutralise them by some antiscandal process before a large number of the public notices them; thus he may influence the balance to his own advantage. It is the majority of favourable, or of unfavourable opinions, in thousands of chances that either makes or mars a doctor.

The practitioner without an enemy suggests a wheat-field without a weed-an impossibility. I have searched out all

sorts and conditions of medical men, and the very best, and most popular, and most guileless man I have ever been able to single out has had his enemies, plenty of them. The reader will perhaps accept this the more readily when I draw his attention to the fact that any man who charges proper fees must have enemies of some kind, at some period or other of his experience. There are some people who would be discontented if they got the whole world as a gift, merely because there appeared so little chance of getting any more worlds on the same terms. A very god of medicine could not please everyone. Even "first come first serve," for nothing, would not suit all, unless the god were capable of ubiquitous and perpetual motion.

There will always be enemies, also, while there are accidents or mistakes made; and there is no man living or dead who has not made mistakes. A member of the laity once gave me full particulars regarding the illness and death of a relative of his. He explained that the recognised greatest professional authority on the particular class of disease the deceased had suffered from had been consulted, but an operation had revealed that his diagnosis had been quite wrong. The patient died as a result of the operation! Thus did this consultant of eminence make enemies. Such is human fallibility!

It is very entertaining to move amongst the laity and hear their accounts and opinions of well-known doctors. One learns this fact, that, as long as people differ, so will opinions and criticisms regarding any man, whether he be a doctor or anyone else. I once built up a practice out of the enemies of all the other doctors in the district. I was young and energetic. I decided to practice in a provincial town, and I put up my plate on the front door of a house there, for richer or poorer. I had not been long in the place before an elderly practitioner called upon me, partly, he explained, on the subject of professional etiquette, but, also, more particularly in order to give me some kindly advice as to my future.

He

heaped up disadvantages of all kinds, telling me of the great mistake I had made in coming to the place, and wound up with the terrible truth that there were already twenty doctors practising in the neighbourhood. I asked him if he would take anything, by way of refreshment, and then casually replied that I should on no account leave the place. I gave him my opinion that any district that could hold twenty doctors could hold twenty-one, if the twenty-first were sufficiently capable. I told him that I was delighted to have an interview with him, being reassured that there was an opening by the very fact that he was prepared with so many arguments that there was not. In the fulness of time, out of the twenty doctors referred to, my interviewer turned out to be the man who suffered most from the building up of my practice.

Any average qualified man can get a living in any place where there are twenty doctors-also getting good livings in practice by merely taking as patients a few of the enemies each man is bound to have. Dissatisfied patients of wellestablished doctors are rather fond of consulting quite a new arrival in the place, provided everything about him seems satisfactory. But he must be an average man: a fool would suffer for his boldness.

Confidence, indeed! Why, to this day I know of people, living in houses having rents of between seventy to a hundred and fifty pounds, who have faith in certain quacks and chemists as against qualified doctors. Let the reader take note of this in considering the subject of confidence. One lady I know has an undying belief in a certain quack herbalist, simply because he once gave her a packet of charcoal to take for her depressed spirits. He used to give charcoal for nearly everything. By accident it helped to cure her dyspepsia, which neither he nor she knew she suffered from, and which was the cause of her feelings of depression. After this she thoroughly believed in

the man for ever as being a miracle worker for every disease. Very trifling things often lead to great convictions.

Single lucky cases are often the cause of everlasting confidence being placed in a doctor's all-round abilities by certain people. A homeopathic practitioner once told me that he built up his fortune upon the reputation that a case of cutthroat once brought him, though he readily admitted to me privately that he had displayed no more than a first-year student's ability over the case. His uprising seemed to have been due rather to the down-fall of another man in the story than anything else. The facts were these: A chicken-hearted practitioner had been asked to see the case first. He was a doctor who had few abilities and very little practice-though, by the way, highly qualified as far as examinations went. When he arrived at the house of the patient he was asked into a room where he beheld the ghastly sight of a man sitting upright in a chair with his throat cut from ear to ear, his head hanging over the back. The blood and general appearance of the case gave him such a shock that he hastily uttered the words, "No hopes, he's gone! I can do no good," and precipitately left the room. He was obviously terrified beyond all control, and instantly concluding that either the man was dead, or that he was certain to die—it did not matter which— he was only too glad to get out of the way of the sickening spectacle. But in the general scramble for a doctor a homeopathic practitioner had been also sent for. He arrived immediately after the nervous man had left. He was told that it was now no use seeing the patient, that a doctor had pronounced him to be dead. He thought he might as well have a look at the man, notwithstanding. He went in and examined the patient calmly. He brought his head forward on his chest, and observed him to be still gasping at very long intervals. He fixed his head and put in a few stitches. He administered strong restoratives, and gave slight hopes. The