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it will always open at the page in use. To do this, open the new book and clip off about a half-inch of the upper corner of all the front fly-leaves-thus -down to the page for the week beginning January 1st. When thus prepared, if, in opening the book, you place your right thumb on the exposed corner of the uncut leaves, it must open at the proper page. Each Sunday morning clip the corner of the page for the ensuing week.

The first visit, also every paid-cash visit to a pay-cash-asyou-go patient, may be easily designated on your visiting-list by turning the first-visit mark (1) into an F, and every paidcash visit into a P, signifying paid.

One's visiting-list can be most conveniently carried in a wide, but shallow, trousers-pocket on the left hip. Seven inches wide, and four and a half inches deep is a good size.

It is well to have a framed copy of the fee-table hung in your office, that you may point to it whenever occasion requires. It is also wise to have a small, neat sign, with "Office Consultations from $1 to $10, cash," posted in some semiprominent place in your office. It will show your rule and tell your charge. It will also remind any who might forget to pay of the fact, and by confronting less honest people will put them in a dilemma. You can, when necessary, point any one to it, tell him your rule, and ask him for your fee; it will also give you a chance to let him know you keep no books for transient office-patients. Such a sign will save you many a misunderstanding and many a dollar. Of course, you can good-naturedly omit its cash enforcement toward patients with whom you have a regular account.

Having your charge from "$1 to $10" will enable you to get a special fee in cases of an extraordinary character, and still allow you to charge minimum fees for ordinary cases. Such a schedule will gratify those who get off by paying the lowest fees, and also tell everybody that you are skillful enough to attend ten-dollar cases.

Cultivate office-practice assiduously, for it is a fertile source of reputation, and also of cash fees; attending patients who are able to go out-doors at the office is also a great saving of time and fatigue to the physician. Strive to benefit and give satisfaction to every patient who comes to consult you, and let every one go away impressed with a belief that the nature of his malady is recognized and understood, and that you will do your best to remedy it, for every man, woman, and child will, while there, form some definite opinion in regard to you, and your professional skill, and will accordingly give you either a good or a bad name.

Keep a few medicines at your office representing the most reliable and frequently employed articles of the pharmacopeia, especially during the first years of practice; handling them will not only familiarize you with their appearance, odor, miscibility, taste, and other characteristics, but also assist you to get your fees from unreliable patients, and from persons who can appreciate advice and tangible remedies combined, but who cannot properly value advice alone. Besides, by keeping cathartic pills, quinia pills, morphia granules, etc., you can send something by the messenger and save yourself many a tramp at night, during storms, on Sundays, and holidays, in emergencies, at odd hours, etc., and give the patient both relief and satisfaction, till you can go.

You have a perfect right to supply this or that patient with medicine if you choose, but very extensive dispensing of your own medicines, or running a rudimentary drug-store, or a pill and globule traffic tends to consume time that might be much better employed and to dwarf one in other ways. Furnishing his own medicines to every patient does not pay, if a physician is established in good, reliable circles, because it is far better for him to base his charges to the majority of them squarely on the abstract value of his time and skill. Besides, one's high tariff and rough compounding would naturally engender the

criticism and enmity of neighboring druggists and others. Never under any circumstances sell medicines to any one but your own patients. If necessary, give them!

If you keep pills, powders, or granules, they can best be dispensed in small envelopes gotten cheaply and kept for the purpose.

Dispatch every professional duty promptly and punctually, so as to get it out of the way of whatever may happen to come after. When summoned to acceptable cases of confinement, colic, convulsions, accident, etc., if possible, lay all else aside and go immediately:—

Here am I.

Then, if you are too late to be of service, you will neither have cause for self-reproach nor be criticised for default of duty. When you cannot go at once without neglecting another pressing case that has a prior claim on your services, or other duties equally as urgent, it is much more satisfactory to your patient if you send a suitable remedy, with instructions for use until you can go, than to write a prescription; because, to send a prescription in such cases seems rather as if you do not sympathize, or as if the patient were on your don't-care-toattend list, and, if the case takes an unfavorable turn, or does not eventuate favorably, you may be blamed and criticised:Of all sad words of tongue or pen,

The saddest are these: it might have been.

When you are the first to reach a patient whose friends have, in the excitement, sent for a number of physicians, with no special choice among them, it is well to have them promptly send a trusty messenger or a courteous note to the others to cancel the call and save them:

A fool's chase,

by informing them their services will not be required.

If, at your office and elsewhere, you make a judicious and intelligent use of your scientific instruments of precision,-the stethoscope, the ophthalmoscope, the laryngoscope, the clinical thermometer, the tape, the microscope, the x-rays, specula, and the reagents necessary to a careful examination of tumors, sputa, calculi, urinary disorders, etc., they will not only assist you very materially in diagnosis, but will also aid you greatly in curing nervous and terrified people, by increasing their confidence in your armamentarium and ability, and enlisting their sympathetic confidence in your remedial treatment.

Carry with you, in your professional rounds, a clinical thermometer, female catheter, bistoury, hypodermic syringe, small forceps, lunar caustic, probe, needles, eic., for ready use. Always cleanse them in the patient's presence before and after using. Never omit to call for a glass of water and napkin with which to cleanse your thermometer, both before and after you make use of it.

Be especially careful to avoid syphilitic inoculation, septicemia, etc., and never use a cut or abraded finger in making vaginal, anal, or oral examinations; if your preferable hand is unsafe, use the other. Vaselin is a good lubricant, it has no affinity for moisture, and keeps for years without becoming rancid or decomposing. Keep a supply in your office for anointing fingers, instruments, etc. Wooden cigar-lighters and tooth-picks are also very handy for making mops, applying caustics, etc. Being inexpensive, each one can be thrown away after one service, instead of being kept for further use, as must be done with expensive articles.

A knife, probe, needle, or other pocket-case instrument can be readily cleaned and disinfected, both before and after using, by thrusting it several times through a wet, well-soaped towel or rag, or into a cake of wet soap.

You should have a special receptacle in your office for cast-off dressings from ulcers, cases of gonorrhea, syphilis,

and other filthy affections, which, when sufficiently accumulated, should be burned.

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With the view to maintain your mental and physical health, you should endeavor to live temperately and comfortably, and to rest as much as possible on Sundays, and sufficiently at night; and, moreover, if you would avoid the risk of a humiliating breakdown, as happens to hundreds of our profession, make it a cardinal point of duty to get your meals and your sleep as regularly as possible; also, to avoid mental worry, and to keep your digestion in order; then you need have but little fear of overwork, or a breakdown from the duties and responsibilities that crowd themselves into your daily life. Remember: it is not mental activity, however great, but mental worry that tends to abbreviate the physician's life. A decent respect for the opinion of the world should lead you to keep within the limits of good taste in everything and to practice all that constitutes politeness in dress and deportment. Be neither a fop nor a sloven, but keep yourself neat and tidy, and avoid everything approaching carelessness or neglect. And as you will be judged by your dress and address, do not altogether ignore the fashions of the day, for a due regard to the customs prevailing around you will show your good sense and discretion. Even though the prevailing style of dress or living borders on the absurd or extravagant, it may still be wise to conform to it to a certain extent :

Though wrong the mode, comply; more sense is shown

In wearing others' follies than our own.

You never heard of a swindler, or a confidence-man, or a gambler, or a pseudo-gentleman of any kind, who dressed shabbily or in bad taste:

These men's souls are in their clothes.

Such people are all close students of human nature, and, no matter how tarnished in character or how blackened in heart,

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