does not exist for the rich doctor. He always has plenty of
genuine cases which can afford genuine treatment; and these
provide him with enough sincere scientific professional work to
save him from the ignorance, obsolescence, and atrophy of
scientific conscience into which his poorer colleagues sink. But
on the other hand his expenses are enormous. Even as a bachelor,
he must, at London west end rates, make over a thousand a year
before he can afford even to insure his life. His house, his
servants, and his equipage (or autopage) must be on the scale to
which his patients are accustomed, though a couple of rooms with
a camp bed in one of them might satisfy his own requirements.
Above all, the income which provides for these outgoings stops
the moment he himself stops working. Unlike the man of business,
whose managers, clerks, warehousemen and laborers keep his
business going whilst he is in bed or in his club, the doctor
cannot earn a farthing by deputy. Though he is exceptionally
exposed to infection, and has to face all weathers at all hours
of the night and day, often not enjoying a complete night's rest
for a week, the money stops coming in the moment he stops going
out; and therefore illness has special terrors for him, and
success no certain permanence. He dare not stop making hay while
the sun shines; for it may set at any time. Men do not resist
pressure of this intensity. When they come under it as doctors
they pay unnecessary visits; they write prescriptions that are as
absurd as the rub of chalk with which an Irish tailor once
charmed away a wart from my father's finger; they conspire with
surgeons to promote operations; they nurse the delusions of the
malade imaginaire (who is always really ill because, as there is
no such thing as perfect health, nobody is ever really well);
they exploit human folly, vanity, and fear of death as ruthlessly