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public is bound, in reciprocity, to make due recognition of the labors of the profession.

The junior physician, wishing to know what particular rules of conduct are best adapted to his professional relations with clients, asks that he may be informed of the nature of the rules by which to be guided in the performance of his duties.

These rules of conduct are excellently stated, in the national system of medical morals, substantially as follows:

The physician is enjoined to be ever ready to obey the calls of the sick; to be imbued with the high character of his mission; to bear in mind that the ease, health, and lives of his patients depend on his skill, attention and fidelity; to unite tenderness with firmness in his deportment and so, inspire his clients with respect, confidence, and gratitude; and finally, he is apprised of the fact that the only tribunal to adjudge penalties for carelessness or neglect is his own conscience.

These provisions and injunctions, though long known to physicians of experience, have to be frequently rehearsed for the information of beginners. There can be no doubt of the necessity to tell young physicians of their duty to obey promptly the calls of the sick; that their mission is one of mercy; that the responsibility they incur in the discharge of their duties is great; and that, since their work is generally done in privacy, the only punishment for carelessness or wilful neglect is through the sting of conscience and loss of self-respect. These injunctions and all others in that system are truly enno

bling and serve, as says Doctor Percival, to soften the manners and expand the affections of the young, and form them to that propriety and dignity of conduct which are essential to the character of gentlemen. How merciful on the part of the physician, how comforting to the patient, when firmness is tempered with tenderness; how noble in the physician to be tenderly firm, and how necessary it often is for him to be condescending, that is, to be yielding in minor details so that his authority may be the greater, in important particulars, for the good of the sufferer! And how can he fail to inspire gratitude, respect, and confidence, if he observe these injunctions in letter and spirit?

However, the devoted, self-sacrificing physician should not lose sight of the fact that the exercise of his profession affords the only means of gaining his livelihood; therefore it becomes him to place a proper valuation on his services. His loyal clients will think the better of him for his own high estimate of good work which they cheerfully recognize pecuniarily, and add to this acknowledgment many expressions of sincere gratitude which is always the true compensation. The "poor patient" is never dismissed from the physician's door without being cared for professionally, and without feeling that something has been done for the relief of his distress which so often requires food and raiment besides medicines and even money; all of which are given freely by the physician more frequently than is generally supposed. But it is not just of the community to demand of physicians the devo

tion, to public medical service, of so much of their time and skill without due pecuniary acknowledgment. The injustice will cease only when members of the medical profession shall insist upon the same rights and emoluments as are accorded to other professional men in public service. Howsoever great may be such emoluments, they can never be an adequate compensation for the hard labor, anxiety, and self-sacrifice of the devoted physician in his endeavors to prevent or cure disease, or to mitigate the sufferings of mankind.

The salient points in the second rule are: that the physician treat his patients with attention, steadiness, and humanity; that he be indulgent to the caprices or mental imbecility of the sick; that delicacy and secrecy be strictly observed; and that the obligation of secrecy extends beyond the period of professional services.

All the clauses of this second rule deserve close attention, but more particularly the third which is of the greatest moment to the patient as well as to the physician. The injunctions of the first and second clauses are intended for beginners who, though they be steady, attentive, and humane in the treatment of their patients, may not have learned certain of the peculiarities of the sick and may, at times, display too much impatience at the whims and the unreasonable demands of some invalids whom the older physicians characterize as querulous and distrustful, but recognize these traits as effects of the diseased condition of, but not as inherent to, the individual whose natural disposition may be gentle and amiable. There

fore, hyperesthetic invalids should not be held accountable for their frequent expressions of impatience or their extravagant actions for all of which the wise physician makes due allowance.

The third clause of this rule is of paramount importance to the physician, to the patient, to the patient's family, to society in general, and to the state. Although paraphrased from the seventh sentence of the Hippocratic Oath, it omits a certain phrase of that seventh sentence which is so suggestive of the wisdom of forming the habit of being silent about the concerns of neighbors. The statement, in the American system of morals, that "the obligation of secrecy extends beyond the period of professional services," evidently does not include the idea conveyed in the Hippocratic Oath; namely: "Whatever in connexion with my professional practice, or not in connexion with it, I may see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret." This admirable moral maxim, with its necessary details, could not have been expressed more tersely and clearly. It surely suggests the cultivation of the habit of keeping a close mouth, a golden silence, regarding occurrences which, directly or remotely, may affect others. Excessive garrulity has too often been the cause of great mischief, of which sad examples are not lacking. Therefore whatever the physician sees or hears, at any time or place, in or out of his professional capacity, that should not be revealed, he is bound in honor, in conscience, to keep it secret from any

person whomsoever. The strict observance of this clause, or rather of the seventh sentence of the Hippocratic Oath, is of importance to the physician because the merely incidental, incautious, mention of an occurrence even such as may seem but trifling, is likely to be magnified in character, with verbal additions, from mouth to mouth, much to the injury of one, and often of more than one innocent person. It is important to the patient because he is naturally unwilling that his ails or affairs be made public. He therefore resents such a breach of faith on the part of any indiscreet attendant or physician; the consequence being loss of confidence in, and cessation of all relations with, a medical man or attendant who discloses secrets. It is important to the patient's family that his secrets be inviolate, even in minor circumstances, because of the exaggerations of scandal mongers. It is important to society at large because violations of professional secrets, and their immediate effects tend to lower the standard of morality. And it is of very much importance to the state as connected with the administration of justice. The client of a physician has every right to his professional services even though the physician ascertain, during his treatment, that the patient is a criminal, no matter of what sort or degree. In such a case, the physician is bound in conscience not to reveal the fact, or a single circumstance connected with the crime, of which he may become cognisant during his attendance. When the physician is summoned to give testimony in a court of justice, he is absolved from replying to any question which he is

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