In order to make myself understood, I will give you an illustration of how personality is abused in the practice of medicine, and the picture here presented is an apt illustration of the conduct of many of the general practitioners, who do not take into consideration the psychological factor in therapeutics.

All observing individuals have noticed that in every locality there are physicians who have more "very sick" patients in proportion to their patronage than others. That the personality of a physician is frequently the prime factor in producing these "very sick patients" is beyond question.

Here is an illustration of the usual conduct pursued by such men in the treatment of an ordinary case of pneumonia, a disease in which the correct use or abuse of the personality of the attending physician, more than in any other acute disease, determines the recovery or nonrecovery of a patient.

"Give this medicine very carefully, and watch her closely until I see her again. I will call this evening."

True to his promise, he is punctual in fulfilling his appointment, much to the satisfaction of the family, who anxiously await his coming. During the day the sick mother has grown more nervous, her temperature is higher, and her pulse rate is faster. She is by this time overanxious about her condition, and this in turn has made her family extremely anxious about her.

The physician has, by his conduct, demeanor, words, and action, made a strong impression upon both patient and family, and the fear that he has thus implanted into the minds of all in the household has kept up a depressing environing influence which has got in its effective work upon the patient.

The lady in question is suffering with acute pneumonia. She feels a decided pain upon breathing, experiences a sense of suffocation, and the paroxysms of coughing have rendered her decidedly conscious of her illness, and now the physician in whom she has placed her trust has looked serious and given directions in a way that speaks louder than words in unduly exciting her. Not one word has he said to allay her anxiety, soothe her mind, assuage her fears, or inspire hope.

Upon his second examination he finds his patient decidedly worse, as might have been expected, and now he is serious sure enough. His fatalities in the treatment of pneumonia have been particularly large, and he much dreads this disease; and, seeing his patient with a higher fever, a more rapid pulse, flushed face, more anxious expression, and remembering his past record with such cases, he makes no effort to conceal his gloomy forebodings.

Again giving directions for the night, he starts for his conveyance, and when out in the hall the members of the anxious family, who have followed him, turn with pleading faces and inquire, "Doctor, how is mother?"

"Very sickr very sick," is his reply. "Watch her carefully tonight. Keep the house as quiet as possible, and, if she should get worse before morning, be sure to call me."

Before the next day he has been called, for his patient has been unable to sleep, and from his point of view a hypodermic of morphin is decidedly indicated.

On and on this management goes, and if finally his patient recovers after two weeks of severe illness, which she might possibly have done in spite of her physician, that family is grateful to God and the doctor for having "pulled her through."

I remember once going to see a lady about fifty-five years old, with acute pneumonia, a decided congestion of the lower lobe of the right lung, and, after carefully making out my diagnosis and prescribing for her medicinally, I turned to the patient and gave her a talk about as follows: "You have pneumonia, Mrs. Blank, but only a mild case; temperature only 103.5° F., but a good pulse, and everything is favorable to a nice recovery. You are in pain, but a hot poultice I have ordered will relieve that very promptly. You will soon get comfortable and will rest well tonight, and be feeling much better tomorrow when I see you again. Now, be patient, and in from seven to ten days you will be well. The medicine prescribed for you will keep you comfortable, strengthen your heart, keep your nerves quiet, steady, and strong, and all will be well with yon."

With tears of gratitude in her eyes, she answered, "Oh, Doctor, you make me feel like I am well already. I feared that I had pneumonia and felt that I never would get well."

"You are going to get well all right," said I, "going along nicely to recovery. Your daughter will have entire charge of your medicines, and knows just what I want you to have in the way of nourishment. After the hot poultice is applied you close your eyes and go to sleep, you will rest nicely, and feel much better when I see you tomorrow."

Upon my return the next day she smiled pleasantly as I entered and bade her good-morning, and when I felt her pulse and remarked, "You are better," she answered, "I feel much better, Doctor."

"Going right along to recovery, madam. Now, I shall see you day after tomorrow."

"See her every day if you think best, Doctor," exclaimed her son. "We want mother to be well real soon."

"I can't trust everybody as I can you, so I will not come tomorrow unless you call me. She is going to do well. Keep out all visitors, continue all directions, and I will see her again day after tomorrow."

I saw that patient only twice more, and at the last visit assured her that it was a pleasure to come into her pleasant family, but that I was going to turn her over to the entire charge of Mrs. Blank, her daughter.

"If you feel it necessary to consult me again, just whistle and I will come."

In about seven more days the son came to know if his mother had better have a tonic; he said she had had no fever for three or four days and was entirely well. Her lung cleared up upon the ninth day of her disease.

I do not mean to say that all pneumonia cases should be seen only four times. In fact, a daily visit or two is indicated in most cases, but the case in question serves to illustrate the part that the psychological factor plays in an ordinary case of illness. Many people die who would get well if given a chance to allow their protoplasmic energies to assert themselves.

Out in California I was invited by a physician to go with him on his rounds through the county hospital. Six pneumonia patients were in one of the wards, four of them old men. The majority of these were chronic alcoholics, and only one was delirious or appeared seriously ill.

"But one death from pneumonia in five years in this hospital," was the physician's record up to that time.

"How do you treat them?" I inquired.

"Keep them comfortable, give them hospital tea (sweet milk), and let them have Old Frank to keep them feeling good." "Old Frank," as the hospital physician styled the genial German superintendent, carried sunshine and good cheer into those wards at least twice a day. He had then been in his place for seventeen years, and the therapeutic value of his personality to that institution would be hard to estimate. He knows how to get the confidence of men and women, and how to keep them feeling good when they are sick. Many a poor tramp, who has seen only the rough side of life, has felt soothed by his kindness, and buoyed up to recovery by his optimism, while being controlled by his firmness.

There is no other disease in which the influence brought to bear upon the mind of the patient so determines the recovery or nonre-covery as pneumonia. It is a self-limited disease, and those influences which soothe the mind and quiet the nervous system bring about a complete re-establishment of the nervous equilibrium, allowing the blood to circulate normally through the peripheral blood vessels of the body, and thus relieve the tension or high pressure upon the heart and inflamed lung, with its fatal termination to pneumonia patients.

One of Old Frank's characteristics is kindness, which is encouraging in contradistinction to sympathy, which is depressing and weakening.

There is more or less mental depression in all pneumonia patients, as the individual is rendered painfully conscious of his helplessness. This results in fear, and such sufferers enjoy sympathy as they enjoy morphin, which inhibits the normal physiological processes and stealthily lessens their resistive powers to the disease. No worse influence can be exerted over the patient than the presence of a highly emotional person, who lavishly pours out sympathy to the destruction of all the optimistic and strengthening qualities of mind and body. So great are the influences brought to bear by the mind over the physiological processes of the body that a physician who unconsciously uses the power of suggestion to the detriment of his patient actually makes a very serious condition out of a trivial disorder. On the other hand, by the intelligent and judicious use of suggestion we can make a very trivial disorder out of a seemingly serious pathological condition, so far as the results are concerned.

The injury done to the unsuspecting public by physicians who are ignorant of the use and power of suggestion is far greater than is commonly supposed. Whole communities have become fear-stricken by the exaggerated serious reports of this class of physicians, who frequently ride day and night to see the victims of their perverted influence. Their very influence in the community in which they live spreads like a contagious disease, emanating from a focus, which stealthily moves among them, reaping financial reward for their indiscretions.

"Very sick, very sick," is their watchword as they implant fear in their trail.

While the laity are being properly educated in the necessity of self-protection from the contagiousness of tuberculous disease, malarial and yellow fever carriers, and other infections, for the safety of their own lives they should also be protected from that pest to any community - the physician who unduly exaggerates the condition of his patients by reporting all cases as being seriously ill.