according to the rent they paid and the fees they gave for professional services-whose drunken husbands had threatened to do them injury, even to murder them. Such cases require a good deal of tact and diplomacy: very commonly an inebriated husband will be inclined to peremptorily ask a doctor, who has been sent for by the wife as being the best man to appeal to under the circumstances, what business he has to interfere. A doctor can scarcely refuse to intervene in such a case, and would run the risk of being considered a coward if he did not attend to render what assistance he could. Former acquaintance between a doctor and drunkard, or even possible friendship, may count nothing at such times. Insults and even assaults upon his person are not at all unlikely to occur under the circumstances. The best method of encountering an infuriated and drunken husband, threatening his wife and everybody else, is that which answers most favourably with any other drunkard; bring yourself down to a comparatively jovial demeanour at first; then insinuate more severe words when you have diverted your man and gained some command over him. Playfully chaff him on first seeing him, and presently you will be able to send him to bed in tears, while he tells you his wife is the best woman in the world.

Sometimes a doctor is sent for by a terror-stricken wife and asked to appear as though he had not been sent for, so that by coming on the scene as it were by mere coincidence he might be able to quell some disturbance going on. I would advise a practitioner to be careful how he sympathises with a wife under these circumstances, or he may get himself and the wife into further trouble. If she run for the doctor on account of his brutality or threatenings, the wife should never be sympathised with in front of the husband; it is better to show no leanings towards either side at the time of intervention. A doctor not long ago, according to the daily press,

got himself into very serious trouble by sympathising with a wife who had been ill-used by a drunken husband. The wife was advised by the doctor, from pure motives of kindness, to take refuge in his own house: he made a rather ignominious appearance in a police court a short time afterwards, as a result, in the role of co-respondent.

In order to handle people of unsound mind successfully, it is necessary to gauge as near as possible the patient's train of thought or bent of mind, and to play upon the demented individual accordingly. Please the patient at first by coinciding with his or her strange ideas, and so gain some sympathetic rapport. A person of unsound mind is better handled as one would a performing animal, by persuasion and tactful inducement, not like a beast of burden that requires prompt castigation. Never show that you are frightened, of either a lunatic or a drunken man; nothing conduces to danger so much as allowing your patient to perceive that it might be possible to gain the least power over you. A drunkard or an insane person will pursue anyone who is frightened—as an animal does when any tendency to shrink back or run away is observed.

If you have any reason to believe that your patient will attack you, or if you should know him or her to be in possession of any dangerous weapon, never threaten or indicate power, but approach as one of the best and cheerfullest of friends. This may sometimes be rather hard to do; but a doctor with plenty of professional opposition and a determination to keep a good practice going, must be equal to anything at any time, and under the most awful circumstances. Then, after getting quite near and on the best of terms, instantly make a bold attempt to overpower the patient and take away any weapon that may be concealed in the hand. There may be other ways of dealing with lunatics that asylum specialists adopt, which I am not prepared to deal with. I am only referring to cases

that may occur in general practice, and I have merely to give whatever measures have been indicated to me in my experience as a general practitioner. Doctors are not infrequently appealed to in dangerous emergencies, and they are more or less obliged to render whatever assistance they can. Sometimes they are consulted as to the best method of getting a patient to an asylum. They must recommend whatever scheme, deception, or ruse they think will suit the case, after ascertaining the patient's train of thought. Women may be made to believe they are getting ready to go to a ball or concert; men may be decoyed by the prospect of having a "lively evening out." By such methods insane people may be removed without the slightest difficulty, and doctors may thus obtain credit for displaying a ready and salutary diplomacy under circumstances very terrifying to those around.

CHAPTER IV

SECRETS OF SUCCESS

It seems hard to have to confess that of all gifts or qualifications that can be possessed by a general medical practitioner, the most valuable—that is, the one leading to the greatest financial success-is style, or manners, or deportment, or demeanour, or whatever may express all these at once. "Manners maketh the man" in medical practice, without a doubt. After the most careful observation over a number of years, after making a study of all sorts and conditions of medical practitioners, I have found nothing that will create success so rapidly and certainly as style. I sometimes prefer the word style to manners, though both words express much the same attribute in the present consideration, and either, to a great extent, is virtually the other. A manner that is courteous and deferential, kind and helpful, considerate and punctilious to please, acts like magic, no matter what other powers a man may have. Style or powers may even overbalance plainness of appearance or strangeness of dress, and can convince the observer that a practitioner must have a a certain amount of mental and professional capacity.

It is of course necessary for a man having a "taking" style to have a certain amount of brains also. Indeed, it is doubtful whether he can have the power to exercise style unless he have brains; though a person may possibly have sufficient brains for style and no more for anything beyond

worth speaking of. Actors are by no means always allround clever individuals. In other words, it is no use for a man to possess style, whether natural or artificial, while he is an absolute fool in scientific knowledge; such a combination, of course, would in the end be sure to be fatal. Yet, I know many examples of medical practitioners who have been described by those who have known them well as very nice men indeed in manners and style, but rather silly and effeminate in certain respects—not, in fact, inspiring confidence. A medical practioner must have some degree of knowledge to back him up, or his manners will only be partly useful to him. To explain more clearly I may draw this distinction: a man may have manners or style and merely common sense, and succeed eminently, like a "quack" for instance; but a man without manners or style, though he have even special sense-being a specialist or a highly qualified general practitioner-will very likely fail as a practitioner.

Quacks have style and a certain amount of common sense. They may have no manners, as ordinarily understood, as belong to ordinary human intercourse, and that is partly why I prefer the word style to manners, for the most part, in this connexion. These individuals can be most successful under the blankest ignorance regarding science or special study. They know how to handle patients, and they have acquired exactly the style that impresses the particular class of people they have to deal with. A quack can convince his patient that he is far cleverer than any six London consultants that may be named, simply by his style and his words; but he may have no social manners worth speaking of; in fact everything in the shape of correct manners may be entirely absent. All medical practitioners require a certain style, to be really successful in keen competition. Their ordinary manners will be more important to them if they practice in South Kensington than they would be in Shoreditch-though it is