WhatshallIsayofthepersonalhabitsyoumustformifyouwishforsuccess？Temperanceisfirstuponthelist。Intemperanceinaphysicianpartakesoftheguiltofhomicide，forthemuddledbrainmayeasilymakeafatalblunderinaprescriptionandtheunsteadyhandtransfixanarteryinanoperation。Tipplingdoctorshavebeentoocommoninthehistoryofmedicine。Paracelsuswasasot，Radcliffewasmuchtoofondofhisglass，andDr。JamesHurlbutofWethersfield，Connecticut，afamousmaninhistime，usedtodrinkasquarebottleofrumaday，withacorrespondingallowanceofopiumtohelpsteadyhisnerves。Wecommonlyspeakofamanasbeingtheworseforliquor，butIwasaskinganIrishlaboreronedayabouthisdoctor，who，ashesaid，wassomewhatgiventodrink。“Ilikehimbestwhenhe’salittlethatway，“hesaid；“thenIcanspaketohim。“Ipitiedthepoorpatientwhocouldnotventuretoalludetohiscolicorhispleurisyuntilhisphysicianwastipsy。
TherearepersonalhabitsoflessgravitythantheoneIhavementionedwhichitiswelltoguardagainst，or，iftheyareformed，torelinquish。Amanwhomaybecalledatamoment’swarningintothefragrantboudoirofsufferinglovelinessshouldnotunsweetenitsatmospherewithreminiscencesofextinguishedmeerschaums。Heshouldrememberthatthesickaresensitiveandfastidious，thattheylovethesweetodorsandthepuretintsofflowers，andifhispresenceisnotlikethebreathoftherose，ifhishandsarenotliketheleafofthelily，hisvisitmaybeunwelcome，andifhelooksbehindhimhemayseeawindowthrownopenafterhehasleftthesick-chamber。
Iremembertoowelltheolddoctorwhosometimescametohelpmethroughthoseinwardgriefstowhichchildhoodisliable。“Faroffhiscoming“——shallIsay“shone，“andfinishtheMiltonicphrase，orleavetheverbtothehappyconjecturesofmyaudience？Beforehimcameasoul-subduingwhiffofipecacuanha，andafterhimlingeredashudderingconsciousnessofrhubarb。Hehadlivedsomuchamonghismedicamentsthathehadatlastbecomehimselfadrug，andtohavehimpassthroughasick-chamberwasastrongerdosethanaconscientiousdiscipleofHahnemannwouldthinkitsafetoadminister。
NeedIremindyonoftheimportanceofpunctualityinyourengagements，andoftheworryanddistresstopatientsandtheirfriendswhichthewantofitoccasions？Oneofmyoldteachersalwayscarriedtwowatches，tomakequitesureofbeingexact，andnotonlykepthisappointmentswiththeregularityofachronometer，buttookgreatpainstobeathispatient’shouseatthetimewhenhehadreasontobelievehewasexpected，evenifnoexpressappointmentwasmade。Itisagoodrule；ifyoucalltooearly，mylady’shairmaynotbesosmoothascouldbewished，and，ifyoukeepherwaitingtoolong，herhairmaybesmooth，buthertemperotherwise。
Youwillremember，ofcourse，alwaystogettheweather-gageofyourpatient。Imean，toplacehimsothatthelightfallsonhisfaceandnotonyours。Itisakindof，ocularduelthatisabouttotakeplacebetweenyou；youaregoingtolookthroughhisfeaturesintohispulmonaryandhepaticandotherinternalmachinery，andheisgoingtolookintoyoursquiteassharplytoseewhatyouthinkabouthisprobabilitiesfortimeoreternity。
Nomatterhowhardhestaresatyourcountenance，heshouldneverbeabletoreadhisfateinit。Itshouldbecheerfulaslongasthereishope，andsereneinitsgravitywhennothingisleftbutresignation。Thefaceofaphysician，likethatofadiplomatist，shouldbeimpenetrable。Natureisabenevolentoldhypocrite；shecheatsthesickandthedyingwithillusionsbetterthananyanodynes。Iftherearecogentreasonswhyapatientshouldbeundeceived，doitdeliberatelyandadvisedly，butdonotbetrayyourapprehensionsthroughyourtell-talefeatures。
Wehadaphysicianinourcitywhosesmilewascommonlyreckonedasbeingworthfivethousanddollarsayeartohim，inthedays，too，ofmoderateincomes。Youcannotputonsuchasmileasthatanymorethanyoucangetsunshinewithoutsun；therewasatranquilandkindlynatureunderitthatirradiatedthepleasantfaceitmadeonehappiertomeetonhisdailyrounds。Butyoucancultivatethedisposition，anditwillworkitswaythroughtothesurface，nay，more，——youcantrytowearaquietandencouraginglook，anditwillreactonyourdispositionandmakeyoulikewhatyouseemtobe，oratleastbringyounearertoitsownlikeness。
Yourpatienthasnomorerighttoallthetruthyouknowthanhehastoallthemedicineinyoursaddlebags，ifyoucarrythatkindofcartridge-boxfortheammunitionthatslaysdisease。Heshouldgetonlyjustsomuchasisgoodforhim。Ihaveseenaphysicianexaminingapatient’scheststopallatonce，ashebroughtoutaparticularsoundwithataponthecollarbone，intheattitudeofapointerwhohasjustcomeonthescentorsightofawoodcock。YouremembertheSpartanboy，who，withunmovedcountenance，hidthefoxthatwastearinghisvitalsbeneathhismantle。Whathecoulddoinhisownsufferingyoumustlearntodoforothersonwhosevitalorgansdiseasehasfasteneditsdevouringteeth。Itisaterriblethingtotakeawayhope，evenearthlyhope，fromafellow-creature。
Beverycarefulwhatnamesyouletfallbeforeyourpatient。HeknowswhatitmeanswhenyoutellhimhehastuberclesorBright’sdisease，and，ifhehearsthewordcarcinoma，hewillcertainlylookitoutinamedicaldictionary，ifhedoesnotinterpretitsdreadsignificanceontheinstant。Tellhimhehasasthmaticsymptoms，oratendencytothegoutydiathesis，andhewillatoncethinkofalltheasthmaticandgoutyoldpatriarchshehaseverheardof，andbecomforted。Youneednotbesocautiousinspeakingofthehealthofrichandremoterelatives，ifheisinthelineofsuccession。
Someshrewdolddoctorshaveafewphrasesalwaysonhandforpatientsthatwillinsistonknowingthepathologyoftheircomplaintswithouttheslightestcapacityofunderstandingthescientificexplanation。Ihaveknowntheterm“spinalirritation“
servewellonsuchoccasions，butIthinknothingonthewholehascoveredsomuchground，andmeantsolittle，andgivensuchprofoundsatisfactiontoallparties，asthemagnificentphrase“congestionoftheportalsystem。“
Oncemore，letmerecommendyou，asfaraspossible，tokeepyourdoubtstoyourself，andgivethepatientthebenefitofyourdecision。Firmness，gentlefirmness，isabsolutelynecessaryinthisandcertainotherrelations。Mr。RareywithCruiser，RichardwithLadyAnn，Pinelwithhiscrazypeople，showwhatsteadynervescandowiththemostintractableofanimals，themostirresistibleofdespots，andthemostunmanageableofinvalids。
Ifyoucannotacquireandkeeptheconfidenceofyourpatient，itistimeforyoutogiveplacetosomeotherpractitionerwhocan。Ifyouarewiseanddiligent，youcanestablishrelationswiththebestofthemwhichtheywillfinditveryhardtobreak。But，iftheywishtoemployanotherperson，who，astheythink，knowsmorethanyoudo，donottakeitasapersonalwrong。Apatientbelievesanothermancansavehislife，canrestorehimtohealth，which，ashethinks，youhavenottheskilltodo。Nomatterwhetherthepatientisrightorwrong，itisagreatimpertinencetothinkyouhaveanypropertyinhim。Yourestimateofyourownabilityisnotthequestion，itiswhatthepatientthinksofit。Allyourwisdomistohimlikethelady’svirtueinRaleigh’ssong：
“Ifsheseemnotchastetome，WhatcareIhowchasteshebe？“
WhatIcallagoodpatientisonewho，havingfoundagoodphysician，stickstohimtillhedies。ButtherearemanyverygoodpeoplewhoarenotwhatIcallgoodpatients。Iwasoncerequestedtocallonaladysufferingfromnervousandothersymptoms。Itcameoutinthepreliminaryconversationalskirmish，halfmedical，halfsocial，thatIwasthetwenty-sixthmemberofthefacultyintowhosearms，professionallyspeaking，shehadsuccessivelythrownherself。Notbeingabelieverinsucharapidrotationofscientificcrops，I
gentlydepositedtheburden，commendingittothecareofnumbertwenty-seven，and，him，whoeverhemightbe，tothecareofHeaven。
Iftherehappenedtobeamongmyaudienceanypersonwhowishedtoknowonwhatprinciplesthepatientshouldchoosehisphysician，I
shouldgivehimthesefewpreceptstothinkover：
Chooseamanwhoispersonallyagreeable，foradailyvisitfromanintelligent，amiable，pleasant，sympatheticpersonwillcostyounomorethanonefromaslovenoraboor，andhispresencewilldomoreforyouthananyprescriptiontheotherwillorder。
Lethimbeamanofrecognizedgoodsenseinothermatters，andthechanceisthathewillbesensibleasapractitioner。
Lethimbeamanwhostandswellwithhisprofessionalbrethren，whomtheyapproveashonest，able，courteous。
Lethimbeonewhosepatientsarewillingtodieinhishands，notonewhomtheygotofortrifles，andleaveassoonastheyareindanger，andwhocansay，therefore，thatheneverlosesapatient。
Donotleavetheranksofwhatiscalledtheregularprofession，unlessyouwishtogofartherandfareworse，foryoumaybeassuredthatitsmembersrecognizenoprinciplewhichhinderstheiracceptinganyremedialagentprovedtobeuseful，nomatterfromwhatquarteritcomes。Thedifficultyisthatthestragglers，organizedunderfantasticnamesinpretentiousassociations，orlurkinginsolitarydensbehinddoorsleftajar，makenorealcontributionstotheartofhealing。Whentheybringforwardaremedialagentlikechloral，likethebromideofpotassium，likeether，usedasananesthetic，theywillfindnodifficultyinprocuringitsrecognition。
Someofyouwillprobablybemoreorlesstroubledbythepretensionsofthatparodyofmediaevaltheologywhichfindsitsdogmaofhereditarydepravityinthedoctrineofpsora，itsmiracleoftransubstantiationinthemysteryofitstriturationsanddilutions，itschurchinthepeoplewhohavemistakentheircentury，anditspriestsinthosewhohavemistakentheircalling。Youcandolittlewithpersonswhoaredisposedtoacceptthesecuriousmedicalsuperstitions。Thesaturation-pointofindividualmindswithreferencetoevidence，andespeciallymedicalevidence，differs，andmustalwayscontinuetodiffer，verywidely。Therearethosewhosemindsaresatisfiedwiththedecillionthdilutionofascientificproof。Nowondertheybelieveintheefficacyofasimilarattenuationofbryonyorpulsatilla。Youhavenofulcrumyoucanrestupontoliftanerroroutofsuchmindsasthese，oftenhighlyendowedwithknowledgeandtalent，sometimeswithgenius，butcommonlyricherintheimaginativethantheobservingandreasoningfaculties。
Letmereturnoncemoretotheyounggraduate。Yourrelationstoyourprofessionalbrethrenmaybeasourceoflifelonghappinessandgrowthinknowledgeandcharacter，ortheymaymakeyouwretchedandendbyleavingyouisolatedfromthosewhoshouldbeyourfriendsandcounsellors。Thelifeofaphysicianbecomesignoblewhenhesuffershimselftofeedonpettyjealousiesandsourshistemperinperpetualquarrels。Youwillbeliabletomeetanuncomfortablemanhereandthereintheprofession，——onewhoissofondofbeinginhotwaterthatitisawonderallthealbumeninhisbodyisnotcoagulated。
Therearecommonbarratorsamongdoctorsasthereareamonglawyers，——stirrersupofstrifeunderonepretextandanother，butinrealitybecausetheylikeit。Theyaretheirownworstenemies，anddothemselvesamischiefeachtimetheyassailtheirneighbors。InmystudentdaysIrememberagooddealofthisDonnybrook-Fairstyleofquarrelling，moreespeciallyinParis，wheresomeofthenotedsurgeonswerealwaysatloggerheads，andinoneofourlivelyWesterncities。SoonafterIhadsetupanoffice，Ihadatriflingexperiencewhichmayservetopointamoralinthisdirection。Ihadplacedalampbehindtheglassintheentrytoindicatetothepasser-bywhererelieffromallcurableinfirmitieswastobesoughtandfound。Itsbrilliancyattractedtheattentionofadeviousyouth，whodashedhisfistthroughtheglassandupsetmymodestluminary。Allhegotbyhisvivaciousassaultwasthatheleftportionsofintegumentfromhisknucklesupontheglass，hadalamehand，wasveryeasilyidentified，andhadtopaytheglazier’sbill。
Themoralisthat，ifthebrilliancyofanother’sreputationexcitesyourbelligerentinstincts，itisnotworthyourwhiletostrikeatit，withoutcalculatingwhichofyouislikelytosuffermost，ifyoudo。
Youmaybeassuredthatwhenanill-conditionedneighborisalwayscomplainingofabadtasteinhismouthandanevilatmosphereabouthim，thereissomethingwrongabouthisownsecretions。Insuchcasesthereisanalterativeregimenofremarkableefficacy：itisastarvation-dietoflettingalone。Thegreatmajorityoftheprofessionarepeacefullyinclined。Theirpursuitsareeminentlyhumanizing，andtheylookwithdisgustonthepersonalitieswhichintrudethemselvesintotheplaciddomainofanartwhoseprovinceitistohealandnottowound。
Theintercourseofteacherandstudentinalargeschoolisnecessarilylimited，butitshouldbe，and，sofarasmyexperiencegoes，itis，eminentlycordialandkindly。Youwillleavewithregret，andholdintenderremembrance，thosewhohavetakenyoubythehandatyourentranceonyourchosenpath，andledyoupatientlyandfaithfully，untilthegreatgatesatitsendhaveswungupontheirhinges，andtheworldliesopenbeforeyou。ThatvenerableoathtowhichIhavebeforereferredboundthestudenttoregardhisinstructorinthelightofaparent，totreathischildrenlikebrothers，tosuccorhiminhisdayofneed。ItrustthespiritoftheoathofHippocratesisnotdeadintheheartsofthestudentsofto-day。Theywillrememberwithgratitudeeveryearnesteffort，everyencouragingword，whichhashelpedthemintheirdifficultandlaboriouscareerofstudy。Thenamestheyreadontheirdiplomaswillrecallfacesthatarelikefamily-portraitsintheirmemory，andtheechoofvoicestheyhavelistenedtosolongwilllingerintheirmemoriesfarintothestilleveningoftheirlives。