fail to receive the full benefit of judicious treatment. If a patient has full confidence in his physician, he should follow strictly, without contention or distrust, all medical directions. If a patient has not full confidence in his physician, it is best for all concerned that another be substituted. The impropriety of professional conversations with physicians not in charge of a case should be understood by patients as well as physicians. A proper sense of propriety will deter the latter from making any inquiries as to the symptoms and treatment, or offering any observations. To. act according to the advice of different physicians, the latter being in ignorance of the fact, is not only dishonorable, but prejudicial to the welfare of the patient. If the advice of more than one be desired, the proper way to obtain it is by a professional consultation, which no physician should ever decline, provided the one proposed to be called in consultation be acceptable to him. To request the services of a consulting physician without the knowledge and consent of the physician in charge is a gross discourtesy, and, if done under circumstances which imply lack of confidence, the latter is fully justified in relinquishing the case. Patients who have lost confidence in their physicians should request discontinuance of their services. So essential is full confidence in the treatment of cases of disease that it is a false delicacy to conceal the want of it. It is best for both the patient and the physician that there be a change. The code states that common courtesy and justice require that, when a physician is dismissed, the reasons should be disclosed. But the loss of confidence is in itself a sufficient reason, no matter how unreasonable the loss may be. A high-minded physician can not wish to continue in charge if he can not have the confidence of the patient. He should take the initiative in the relinquishment of the case whenever he is satisfied that confidence is lost. The reasons for the loss of confidence in some instances may be as indefinite as in the following familiar lines: "I do not like thee, Dr. Fell; The reason why I can not tell; Now, under such circumstances, Dr. Fell should be satisfied with the information conveyed by these lines, and retire from the case. The inability to systematize his work is a great drawback to the comfort of the medical practitioner. Patients can do not a little toward relief in this regard by observing the injunctions contained in the ninth section of the article of the code now commented upon. This reference suffices for that section. The tenth and last section of the article expresses a truth which, for the majority of patients, need not have been expressed. The feelings of a patient at the time of recovery from disease, as contrasted with those at a later period, have furnished a subject for jests and humorous illustrations; but "a just and enduring sense of the value of the services rendered him by his physician" is felt by the patient as a rule, and the degree of grateful appreciation of these services by the many more than compensates for a lack of this appreciation by the few. CHAPTER II. OF THE DUTIES OF PHYSICIANS TO EACH OTHER AND TO THE PROFESSION AT LARGE. ART. I.-Duties for the Support of Professional Character. SECTION 1. Every individual, on entering the profession, as he becomes thereby entitled to all its privileges and immunities, incurs an obligation to exert his best abilities to maintain its dignity and honor, to exalt its standing, and to extend the bounds of its usefulness. He should, therefore, observe strictly such laws as are instituted for the government of its members; should avoid all contumelious and sarcastic remarks relative to the faculty as a body; and, while by unwearied diligence he resorts to every honorable means of enriching the science, he should entertain a due respect for his seniors, who have, by their labors, brought it to the elevated condition in which he finds it. SECTION 2. There is no profession from the members of which greater purity of character and a higher standard of moral excellence are required than the medical; and to attain such eminence is a duty every physician owes alike to his profession and to his patients. It is due to the latter, as without it he can not command their respect and confidence, and to both, because no scientific attainments can compensate for want of correct moral principles. It is also incumbent upon the faculty to be temperate in all things, for the practice of physic requires the unremitting exercise of a clear and vigorous understanding; and, on emergencies, for which no professional man should be unprepared, a steady hand, an acute eye, and an unclouded head may be essential to the well-being, and even to the life, of a fellow-creature. SECTION 3. It is derogatory to the dignity of the profession to resort to public advertisements, or private cards, or handbills, inviting the attention of individuals affected with particular diseases-publicly offering advice and medicine to the poor gratis, or promising radical cures; or to publish cases and operations in the daily prints, or suffer such publications to be made; to invite laymen to be present at operations, to boast of cures and remedies, to adduce certificates of skill and success, or to perform any other similar acts. These are the ordinary practices of empirics, and are highly reprehensible in a regular physician. SECTION 4. Equally derogatory to professional character is it for a physician to hold a patent for any surgical instrument or medicine; or to dispense a secret nostrum, whether it be the composition or exclusive property of himself or of others. For, if such nostrum be of real efficacy, any concealment regarding it is inconsistent with beneficence and professional liberality; and if mystery alone give it value and importance, such craft implies either disgraceful ignorance or fraudulent avarice. It is also reprehensible for physicians to give certificates attesting the efficacy of patent or secret medicines, or in any way to promote the use of them. The late Alexander H. Stevens, in his acknowledgment of the honor of an election to the presidency of the American Medical Association, at its first annual meeting in 1848, spoke of the profession of medicine in the following terms: "Our profession, gentlemen, is the link that unites Science and Philanthropy. It is one of the strongest ligaments that binds together the elements of society. It teaches the rich their dependence, and elevates the poor to a sense of the innate dignity of their nature. Its aim is to add to the comfort and duration of human life. In a country where population is not crowding on the means of subsistence, and where every individual has the largest opportunity of promoting his own happiness and of perpetuating it in his posterity, the medical profession, entirely philanthropic in its objects, more intimately connected with the pursuits of science than the other learned professions, and not overshadowed by an hereditary aristocracy, enjoys pre-eminently a high social position, and, for all legitimate objects, a commensurate influence." Eulogiums equally glowing, in view of its beneficent objects, have come from speakers and writers not of the medical profession. It is not a small thing to belong to a profession so much honored, and plainly it is the duty of its members to do nothing to impair, but everything to sustain and promote, its honorable character. It may be said that the sentiments expressed in relation to the "duties for the support of professional character," contained in the two first sections under this head, are mere truisms and platitudes. This may be said with regard to any collection of ethical principles for the regulation of human conduct. Experience shows the importance of the embodiment in language of moral principles pertaining to other of the relations of life, and there is reason to believe that this portion of the code has had not an inconsiderable influence upon the character of the profession by inciting its members to become worthy of it, and to render it still more worthy of the estimation in which it is generally held by the public. There can be no difference of opinion in the minds of worthy physicians as to the acts which in the third section. of this article are specified as derogatory to the dignity of the profession. But the propriety of the interdiction of these acts by the code is not always appreciated by the public. As a reason for their being interdicted as "highly reprehensible in a regular physician," it suffices to say that "they are the ordinary practices of empirics." The public should understand that these practices are criteria of irregular or unworthy practitioners. With this understanding, if persons consent to be influenced by such acts, the responsi |