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he does not put his questions without weighing them first. "How is the cough ?" "Easier, I think," says the patient. Did you sleep well?" "Yes, on the whole. Had one bad bout at three !" "Have you had your breakfast?" "Yes." 66 Enjoyed it?" "Very fairly." "What did you have?" "A piece of boiled turbot, and a slice of bread and butter." "What are you going to have to lunch?" "I don't know." Old lady puts in her oar. I have brought some oysters, doctor. May he have some?" Of course he may; and a neatly-turned compliment about her discretion, as well as her kindliness, wins the old lady's good opinion. Dextrous old gentleman that! He may not know his pathology, or be familiar with the microscope; indeed, he may be shockingly ignorant about glycogen, and not know a peptone from a proteid"; but he knows human nature, and the practice of physic as adapted to gentlefolks, a precious sight better than you yet do; my promising hospital fledglings! Harmony prevails: golden opinions are obtaining all round. Will he have a glass of Hock or Sauterne with the oysters?" That is an important detail to settle. Sauterne ultimately carries the day. The doctor is very exigeant about his promising not to stay up too long; orders the medicine to be continued: throws in a brief side inquiry about the bowels; finds they have not moved, so orders a pill to be taken at bed-time. Then he shakes hands with the patient with repressed emotion, telling him how glad he is that he is going on so nicely; turns round to the old lady, shakes hands with her with a distant courtesy, indicating his deep respect for her; and expresses his satisfaction at having made her acquaintance, with an unquestioning honesty and earnestness; bows pleasantly as he takes up his hat, and disappears: leaving behind a feeling of satisfaction and an impression that his visit is as welcome as a gleam of sunlight in a showery April day. Such is the practice of medicine among the better classes it involves good breeding, polished manners, keen observation, veiled by a pleasant urbane behaviour as well as a kindly interest, as indicated by the turn of the conversation. Yes, my young friend, the reader, your father may spend a lot of money upon your educa

tion; but that is a part of it you will have to learn for yourself, and it will take many additional years for its acquisition; but it will be of incalculable value to you, when you have acquired it.

Or you are calling upon a girl of fifteen who has been down with pneumonia, and is recovering rapidly: it is in the morning. You ask "How have you slept?" "Had your breakfast? Did you enjoy it?" If an afirmative answer be given you know the patient is progressing satisfactorily; and you can amuse her and instruct yourself by examining the state of the lung, and seeing how fast it is clearing up. This done you can proceed. "Well, do you feel inclined to get up?" "Very much!" or, "I should so like to." Now you remember quite well that though a patient feels very equal to getting up while still in bed, it becomes another matter when the attempt is actually essayed; therefore you look as wise as you know how, and ask-" Are you going to be up wrapped in a blanket; or are you going to be dressed?" 66 Going to be dressed, of course!" is the answer. Now, dressing taxes the patient's strength; and then, when the patient has sat up till tired, the undressing is often very wearying; and instead of being delighted at having been up, the patient complains of exhaustion, and probably sleeps badly after it. Now, it is very desir. able that a convalescence never be checked, but go on progressively. Therefore, for the first day or two the patient should not be dressed; if the being up is well borne, the dressing may follow. But insist that the first day of the dressing the patient only be permitted to sit up an hour; allowing for the dressing and undressing.

In the same way you act cautiously when the patient is well enough to get out of doors. You remember that the patient has been in bed, or in a warm room only, for some time; and you also remember what your physiological lecturer told you about the rabbits that were kept some time in a warm chamber, that they did not conserve their heat well for some time after, and that their temperature fell in consequence. Very well, remembering this, you ask-"How far do you intend to go?" "Are you going to be driven in an open or a covered conveyance?" Or

if a stroll in the garden is contemplated, you bear in mind the patient cannot walk quickly enough to keep up the body heat, and so insist in either case about the necessity for plenty of "wraps ;" the lighter the better, as the patient cannot well bear any great weight. Yes, and make a point of inquiring into the character of the wraps, their sufficiency and warmth. Then add any advice the circumstances require, or your wisdom may suggest; and do not be at all surprised if your caution is liberally discounted, and the patient gets some cold, despite your reiterated warnings and all your good counsel.

A little physiological knowledge often serves you well in practice; if you have not only got the knowledge but know how to apply it. And to remember how the rabbits, after an experience in a warm chamber, could not keep up their body-temperature, is often to be able to give sound advice; and such little bit of physiology will be useful to you fifty times for once you will have an opportunity of airing your acquaintance with the origins and insertions of the muscles of the thigh, or of comparing the right and left astragali; indeed, than all your fore about "the dry bones of the valley of Ezekiel," upon which such a terribly large proportion of your student time is expended. Your anatomy may be the cardinal matter of your education in an antiquated system of medical teaching, and while before an examiner; but you may take my word for it, without requiring corroborative evidence of its validity, your physiological knowledge is what will stand you in most stead when you get into practice; and the more you know of the normal processes of the body and the facts taught by experimentation, the better practitioner you will be. Remember, also, that there is much told you by your physiological lecturer that is intended for the examination table, as well as for use in daily practice. You will hear much of the propriety of giving a part "physiological rest," as in laying up a sprained ankle; putting a strained joint into a leather case, so as, for the time, to prevent its being a joint; or even applying a Sayres' jacket to a bending spine: but you will have to reason out for yourself the desirability of sending a patient to bed for several days after a severe

shake which has involved the contents of the skull; or even of shaving off the raised prominences of cuticle in a scratch, the results of which are very grateful to the patient; but don't take my word for it on this little matter, but just try it and see. They catch at everything which comes near them; shave them off, and all such irritation is avoided; the scratch is rendered comfortable and the healing process goes on kindly.

CHAPTER IV.

PRACTICAL EXAMPLES.

Now my reader and I, my vanity inclines me think, are getting on sufficiently intimate terms to pursue together this subject further, without falling out with each other, or quarrelling. In this chapter some well-marked examples of the instances where incisive questions may be asked with advantage, will be given; but it must not be supposed that any attempt is being made here to exhaust the subject, or to go into abstruse matters. Such illustrations only will be given as will demonstrate the practical utility of well-placed interrogations.

We may commence with the head. A patient complains of headache. You first ask him, "Where?" He refers it to a certain part; you examine it carefully, inspect, feel it. You see some injury, or bruise. Your way is then clear before you. There is nothing to see, but you feel a lump. Is it a bruise or a swellingosteal or periosteal? Now you know that the characteristic of such pain is that it is nocturnal. So you ask, "Is the pain worst at night?" The answer is in the negative. Keep your eye open to the possibility of a neuroma, though they are not commonly seated on the scalp. But the patient replies in an energetic affirmative. You then immediately suspect syphilis; nevertheless, it may be due to injury, or other cause, This form of pain is connected with the skull rather than its contents. Rheumatism of the scalp is not a rare affection. In many cases, however, you see or feel nothing to help

you.

So you ask the patient to place the hand on the seat of pain. It is placed over the forehead. You then suspect