this cause. On the other hand, many patients look with a degree of jealousy on visits which they think unnecessarily repeated. After all, the medical man is the best judge of the necessity of his visits, and of the urgency and danger of the patient's case. Of course delicacy should be exercised where the patient's circumstances are narrow, lest a feeling of anxiety should be created as to the expense incurred. In such cases the feeling and benevolent practitioner is called upon to exercise a degree of self-sacrifice, and to make now and then an extra visit as if incidentally, and for his own satisfaction.

There is another point to which we wish to refer whilst on the subject of visits, and that is, medical visits on the Sunday. There is a great difficulty in drawing a line of demarcation as to when they ought and when they ought not to be paid. For our own part, we consider that when they can be dispensed with without injury to the patient they ought to be, both for the sake of securing to the medical man as much as possible of that sacred rest which he as well as other men needs, and for the sake of the family of the patient, who being on that day probably assembled together, feel the visit of the medical attendant, if not really called for by the urgency of the case, an unseasonable and unwelcome intrusion. Where active disease is going on of course this does not apply; but wherever, by proper management on the Saturday, the Sunday visit can be avoided it ought to be done. Percival says on this subject, "The observance of the Sabbath is a duty to which medical men are bound, so far as is compatible with the urgency of the cases under their charge. Visits may often be made with sufficient convenience and benefit, either before the hours of going to church, or during the intervals of public worship. And in many chronic ailments, the sick, together with their attendants, are qualified to participate in the social offices of religion,

and should not be induced to forego this important privilege by the expectation of a call from their physician or surgeon."

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We may add, that if the medical man be one who has a due sense of the highest interests of mankind, he may, without at all going out of his appropriate sphere, take occasion by a few natural remarks, the recommendation of a book, &c., contrive to make his Sunday visit a moral benefit to his patient.

The last point which requires notice is how far it is right for the physician to continue his visits when the disease is incurable. "Sir William Temple has asserted, that an honest physician is excused for leaving a patient when he finds the disease growing desperate, and can, by his attendance, expect only to receive his fees, without any hopes or appearance of deserving them. But this allegation is not well founded, for the offices of a physician may continue to be highly useful to the patient, and comforting to the relatives around him, even in the last period of a fatal malady, by obviating despair, by alleviating pain, and by soothing mental anguish. To decline attendance under such circumstances would be sacrificing to fanciful delicacy and mistaken liberality that moral duty which is independent of, and far superior to, all pecuniary appreciation."*

Simon says on this point-"The duties of a medical man with regard to maladies of this kind, vary according to circumstances, of which we shall here point out the principal. Amongst really incurable diseases there are a certain number in which a wise and judicious treatment, a hygiene, which embraces at once the physical and moral regimen of the invalid, may indefinitely retard the fatal termination. There are others which call more specially

* Percival.

for the employment of palliatives, and in which we are permitted to deprive suffering of part of its bitterness, and to render the endurance of existence less painful. In the few remaining maladies which do not admit even of palliation, and where art finds itself completely disarmed, the office of the physician is changed, but by no means at an end. His very presence is a comfort and encouragement, and if he possesses those qualities of the mind and heart which Lancisi, Baglivi, Antoine Petit, Cabanis, J. Frank, Hufeland, and many others, have shown to exercise so powerful a control over the moral, and consequently over the physical nature of suffering man, he may be eminently useful in employing, for the benefit of the invalid, that ascendancy which those precious qualities secure to him."

One other remark in the Letter to Tulpius we must not pass unnoticed. It is what is said of his respect for the powers of Nature. This is a point in medical practice which should never be lost of. "Inest enim corpori vis prorsus mirabilis, qua contra morbos se tueatur multos arceat, multos jam inchoatos quam optime et citissime solvat, aliosque suo modo, ad felicem exitum lentius perducat." One of Marx's Aphorisms beautifully expresses the regard which a medical man should have for the Vis Natura Medicatrix. "The wise physician treats the healing power of Nature as the sunflower the sun; he follows it until it becomes invisible." All medical practice is founded upon the principle of restoring the deranged functions of the body to their normal state, and he will best succeed in the practice of his profession, who most closely watches the performance of these functions, both in health and disease, and the efforts made by Nature to restore them when deranged, adapting his treatment in such manner as to produce the same effect.

BIOGRAPHICAL NOTICE OF PHILIP PINEL.

Philip Pinel was born on the 11th of April, 1745, at St. Paul, a village near the town of Castres, which is now included in the département du Tarn. His father practised medicine and surgery; his mother was a model of piety; but his parents had a numerous family and a very moderate fortune. They sent their son Philip first to the college of Lavaur, where he received the first principles of education; but as he was destined for the church, he was removed to the school of Toulouse, where he followed a course of philosophy under a professor who assisted him in becoming an excellent mathematician. He now desired to commence the study of theology, but circumstances altered his intentions. With the consent of his father he quitted the university, and having freed himself from all dependence on his friends, he commenced giving lessons in mathematics and philosophy. He tried for, and obtained, the floral wreath for his proficiency, and by his own exertions earned sufficient to follow his medical studies. He was for some years chosen by one of the professors as his assistant, and ultimately, on the 22d of December, 1773, after having undergone his examination with great honour to himself, he received the title of Doctor. Pinel was then in his 29th year, and his prospects were not the most brilliant. He had lost his father, and could not expect

anything from his family, while the small profits of his teachings were scarcely sufficient for his present necessities, and he looked at the future with anxiety. The hope of bettering his circumstances, and, above all, of increasing his knowledge, induced him to go to Montpellier, where he arrived in 1775. The school of this celebrated town was then in all its glory, for although it no longer had either Fizes or Sauvages, yet the wisdom of Barthez, the knowledge and eloquence of Zamure, Leroi, Venel, and Gouan, as professors, and the talents of Vigaroux, Chaptal, and Fouquet, as practitioners, gave to Montpellier a glory which was not equalled by any other medical school in Europe. Pinel had hardly arrived at this modern Cos when he found both an asylum and support in the family of M. Benezech, where he was received as tutor to his son, a youth who afterwards became truly a man of genius. While devoting himself in this manner to the education of his pupil, he employed his leisure hours in increasing his medical knowledge, in attending some courses of chemistry and natural history, and in perfecting himself in the Greek and English languages. He also composed theses for young students. These theses, written correctly and with elegance, were looked upon as fine examples of Latinity. Much was in this way required of him, and what especially proves the wisdom and moderation of his mind, he almost invariably took for his subject some question of hygiene; for if there is in medicine anything of certainty or probability, it is assuredly in questions of this nature. With regard to those high questions of medical philosophy which at a future day he was to treat with so much vigour and clearness, and which have usually such an attraction to the inexperienced and imaginative, Pinel never touched on these at this time. Perhaps, with the eye of a master, he perceived that his mind had not then attained its necessary maturity, or he thought that the spirit of sys