will have to endure is the tendency of patients who have suffered wrecking sickness to blame you or your medicine for any permanent impairment or lingering symptoms, instead of recognizing and acknowledging the fact that they are purely the sequels of their disease.

"Iron injures the teeth" is a remark which you will often hear, and it originates in the fact that the old muriated tincture of iron (tinct. ferri chloridi), which contains muriatic acid, if given without proper caution will injure the teeth, not on account of the iron, however, but of the acid that is associated with it; just as hot water in a pot of boiling coffee would scald a person all the same if the coffee were not in it. If a preparation of iron contains no free acid it will not act upon the teeth.

Iron does temporarily blacken the coat on the tongue and the stools; and it is well to tell patients this to prevent needless alarm when these are discovered.

It is believed by many that quinia gets into the bones, affects sight and hearing, salivates, causes dropsy, etc. So firmly do some people believe these things that you will have to humor their prejudices, and change to sulphate of cinchonia, compound tincture, or some other preparation of bark, when bark is indicated.

This prejudice depends chiefly on the fact that, being powerful for good, people naturally infer that it must be awfully strong; hence, also, powerful for evil. It is also often due to the teachings of "the enemy," who seek to prejudice the public against its use by regular physicians, while constantly, but secretly, using it themselves. We have known a conspicuous Irregular to denounce quinia strongly, and yet use 3-grain, gelatin-coated quinia pills under the name of "Panama Beans" for the cure of his patient. We know that quinia, when properly used, is an almost harmless vegetable product, which acts on the malarial poison not by great

strength, but through its antidotal influence, just as water, an agent harmless enough to drink or bathe in, acts on fire.

Reproach is often unjustly cast on physicians and on medicine by people living in malarious districts, who sicken with this or that malarial affection, send for a physician, and get well, and would remain so, but, being still surrounded by malaria, they again inhale it and are again poisoned. This they erroneously call "a return," instead of a repoisoning. Of course, while the laws of his majesty, King Malaria, remain as they are, you can no more promise future immunity to convalescents with agued frames who remain in malarious districts than you can promise the anxious sailor that future winds will not again create waves, or the uneasy farmer that recurring frosts will not again nip his exposed plants, or the fellow you pull from the water that he can henceforth fall overboard without getting wet.

Malarial germs are encountered at night, and most on the still, damp nights of autumn. Malarial affections, therefore, are usually contracted in autumn and at night, but many people are ignorant of the fact that they can also rise and be inhaled during the greater part of the year; they can also be encountered in daytime; therefore, all such persons should be put on their guard.

It is proper, and also your duty, to advise a person to change his abode if necessary for his health, or to relinquish an occupation if it be injurious to him. Also to dissuade him from exciting pastimes or from overstraining to amass riches when his health is thereby jeopardized; at the same time be on your guard, for such subjects are both important and delicate to meddle with.

Keep yourself well informed in regard to suitable clothing, physical exercise, and proper diet; also as to the value of pure air, pure water, and pure soil, the comparative healthfulness of different regions, the presence or absence of malaria

at different seasons and places, and in regard to the various health trips and summer resorts.

Also familiarize yourself with the constituents and peculiarities of the various mineral waters; with the comparative advantages of seaside and mountain trips, salt air versus country air, and with the classes of invalids to be benefited by one or other; also with the various baths-hot, cold, tepid, Russian, Turkish, electrical, vapor, electrodynamic, etc.-and the comparative advantages of the various hospitals, asylums, sanitaria, retreats, etc.; for such matters belong strictly to the province of medicine, and it is especially desirable that you should understand them, because you are sure to be asked about them, and sure to be ashamed if you cannot answer, and the refined and intelligent inquirer will see by your confused manner, weak language, and erroneous conclusions that you are beyond your depth, and will feel disappointment and distrust of your knowledge; because these are subjects that concern the better and more desirable classes of patients, many of whom are semi-invalids, with whom hygiene, medicinal waters, trips, etc., go hand in hand with medication.

Also remember that your duty does not always terminate with the cure of the malady which you are called upon to treat, for in almost every case you should lay down rules and regulations to prevent a relapse, sequels, or future attacks.

You will often find it very beneficial to get a convalescent patient to country, mountains, or seashore, amid cheerful surroundings that do not recall his illness. A change of air is less valuable than a change of scene. The air is changed every time the wind blows or shifts; the scene is not.

You cannot be too cautious in advising exhausted patients with impaired appetite and weakened digestion, or far gone with obstinate and dangerous or hopeless maladies, to leave their homes and undergo the fatigues and discomforts of travel to the seashore, mountains, or other distant places, or to

foreign countries, among strangers, in search of health, unless there exist sound and strong reasons for the belief that the change will be beneficial and that improvement or restoration to health will result. The risk of breathing their last away from home, family and kindred, or of a return made worse by the inevitable fatigue and exposures of travel, is not to be assumed without careful consideration. We sometimes actually hear it hinted that the physician has sent this or that patient away to get rid of him, or because he did not know what other treatment to give him.

Also never send a patient, or any one else in whom you are interested, from his home, to the crowded wards of a hospital unless his case clearly requires it, as in important surgical operations demanding anesthesia, aseptic precautions, special instruments, assistants, etc., or patients who have no proper place for operating and no conveniences for the subsequent treatment, or requiring this or that thing not possible for you to procure. For while hospitals and almshouses are an unspeakable blessing to sick wanderers, unsheltered castaways, the forgotten, and indigent strangers, they are, to a less extent, sometimes not at all so to one who has relatives and friends and a place to call home.

To remove a depressed and worn invalid from the spot he calls "home" to a hospital or other asylum for poverty, when these things do not compel it, deprive him of his friends, neighbors, and companions and all the little endearing sympathies and solaces of domestic life, restrict his freedom by slave-like discipline and half-way imprisonment, and subject him to the sense of friendlessness that is too apt to seize the mind in the hours of sickness and to the foul effluvia, the smell, and the diseased emanations that lurk about the wards of hospitals and to the risk of rugged indifferences on the part of paid, possibly coarse nurses, and to irksome, humdrum:

Red Tape, Red Tape, everything dominated by Red Tape,

hospital rules-to bed, to meals, to everything at the sound of the bell, gong, or whistle; to expose him possibly to the public gaze, merely as an object of medical treatment, or for experiment with new remedies, or for the clinical advantage of medical students, designate him by a number, clothe him hospital fashion, hang a case-card at his head, and put him on diet served at regulation hours by stranger hands that know not his peculiarities or tastes, his likes and dislikes-if he be a person of domestic taste and sensitive disposition, with a natural attachment to his home, such a change would be both injudicious and hurtful and could scarcely fail to aggravate his disease. Worse still, if he be carried to a medical-college hospital, with its busy crowd, shuffling feet, wilderness of gazing eyes, and sea of eager faces gathered around while he is used as a subject for the demonstration of his disease, or carried through repeated or prolonged examinations for the education of students. No! No! both nature and common-sense forbid!

The belief that taking water or ice is dangerous in fever is still very general. People are wonderfully slow to recognize the fact that water, whether applied externally or sipped and swallowed in small quantities at a time, is one of Nature's greatest remedies in fever, etc., especially if the patient have a craving for it.

You will often be asked: "Doctor, may the patient eat anything he wishes?" If you think that ordinary food will do him no injury, be careful to answer: "Yes; he may have any simple thing he wishes." Were you to say: "He may have anything," it would include pickles, radishes, cheese, ham, veal, sausage, cabbage, and a great many other indigestible things that might injure or kill him; the addition of the adjective simple will protect both him and you.

You can have some small, single-page diet-lists printed for the use of your patients, containing every article of diet