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 as their own health, strength, and patience are exploited by selfish hypochondriacs.  They must do all these things or else run pecuniary risks that no man can fairly be asked to run.  And the healthier the world becomes, the more they are compelled to live by imposture and the less by that really helpful activity of which all doctors get enough to preserve them from utter corruption.  For even the most hardened humbug who ever prescribed ether tonics to ladies whose need for tonics is of precisely the same character as the need of poorer women for a glass of gin, has to help a mother through child-bearing often enough to feel that he is not living wholly in vain.

THE PSYCHOLOGY OF SELF-RESPECT IN SURGEONS

The surgeon, though often more unscrupulous than the general practitioner, retains his self-respect more easily.  The human conscience can subsist on very questionable food.  No man who is occupied in doing a very difficult thing, and doing it very well, ever loses his self-respect.  The shirk, the duffer, the malingerer, the coward, the weakling, may be put out of countenance by his own failures and frauds; but the man who does evil skilfully, energetically,