the physician has to pronounce a verdict of fatal character.

There is another matter of moment as to cases known to be hastening to a
fatal conclusion. The responsibility of withholding this knowledge from
the patient is usually shifted on to the shoulders of relatives or
friends. The medical adviser reports to them his opinion and leaves with
them the power to act.

He is often asked if to know that death seems certain makes less the
chance of recovery or shortens the lessening number of the days of life
yet left. It has often fallen to my sad lot, as to that of many of my
medical brothers, to have to tell a patient that he is to die. Some
isolated man asks it. Some lonely hospital patient has just reasons for
knowing early or late in his disease the truth as the doctor sees it. I
have never been able to feel certain that in any case of acute or
hopeless illness to know surely what lay before a sick man did
distinctly shorten his life. I have seen many people in apparent health
made ill by the shock of emotion,--by fear, grief, anger, jealousy.
Diseased persons feel less, or show less in a physical way, the results
we might expect to see from even the most rudely conveyed intelligence
as to their probable future.

It was not my wish to enter into a long discussion of all the qualities
which go to make up the ideal physician. I desired chiefly to consider
his principal needs, to point out in big defence certain of his
embarrassments, and to leave the reader with some sense of help towards
knowing whether his adviser was such as he should be in the more
important qualities which go to make the true physician. There are other
and minor matters which are not without their relative gravity in his
life. Some are desirable but not truly essential, and yet help or hurt