We had a physician in our city whose smile was commonly reckoned as being worth five thousand dollars a year to him, in the days, too, of moderate incomes.  You cannot put on such a smile as that any more than you can get sunshine without sun; there was a tranquil and kindly nature under it that irradiated the pleasant face it made one happier to meet on his daily rounds.  But you can cultivate the disposition, and it will work its way through to the surface, nay, more,—­you can try to wear a quiet and encouraging look, and it will react on your disposition and make you like what you seem to be, or at least bring you nearer to its own likeness.

Your patient has no more right to all the truth you know than he has to all the medicine in your saddlebags, if you carry that kind of cartridge-box for the ammunition that slays disease.  He should get only just so much as is good for him.  I have seen a physician examining a patient’s chest stop all at once, as he brought out a particular sound with a tap on the collarbone, in the attitude of a pointer who has just come on the scent or sight of a woodcock.  You remember the Spartan boy, who, with unmoved countenance, hid the fox that was tearing his vitals beneath his mantle.  What he could do in his own suffering you must learn to do for others on whose vital organs disease has fastened its devouring teeth.  It is a terrible thing to take away hope, even earthly hope, from a fellow-creature.  Be very careful what names you let fall before your patient.  He knows what it means when you tell him he has tubercles or Bright’s disease, and, if he hears the word carcinoma, he will certainly look it out in a medical dictionary, if he does not interpret its dread significance on the instant.  Tell him he has asthmatic symptoms, or a tendency to the gouty diathesis, and he will at once think of all the asthmatic and gouty old patriarchs he has ever heard of, and be comforted.  You need not be so cautious in speaking of the health of rich and remote relatives, if he is in the line of succession.

Some shrewd old doctors have a few phrases always on hand for patients that will insist on knowing the pathology of their complaints without the slightest capacity of understanding the scientific explanation.  I have known the term “spinal irritation” serve well on such occasions, but I think nothing on the whole has covered so much ground, and meant so little, and given such profound satisfaction to all parties, as the magnificent phrase “congestion of the portal system.”

Once more, let me recommend you, as far as possible, to keep your doubts to yourself, and give the patient the benefit of your decision.  Firmness, gentle firmness, is absolutely necessary in this and certain other relations.  Mr. Rarey with Cruiser, Richard with Lady Ann, Pinel with his crazy people, show what steady nerves can do with the most intractable of animals, the most irresistible of despots, and the most unmanageable of invalids.