ful and so trustworthy is this
face-picture when analyzed, that our best and most depended upon
impressions as to the actual condition of patients, are still obtained
from this source. Many and many a time have I heard the expression from
a grizzled consultant in a desperate case, "Well, the last blood-count
was better," or, "The fever is lower," or, "There is less albumen,--but
I don't like the look of him a bit"; and within twenty-four hours you
might be called in haste to find your patient down with a hemorrhage, or
in a fatal chill, or sinking into the last coma.

It would really be difficult to say just what that careful and loving
student of the _genus humanum_ known as a doctor looks at first in the
face of a patient. Indeed, he could probably hardly tell you himself,
and after he has spent fifteen or twenty years at it, it has become such
a second nature, such a matter of instinct with him, that he will often
put together all the signs at once, note their relations, and come to a
conclusion almost in the "stroke of an eye," as if by instinct, just as
a weather-wise old salt will tell you by a single glance at the sky
when and from what quarter a storm is coming.

I shall never forget the remark of my greatest and most revered teacher,
when he called me into his consultation-room to show me a case of
typical locomotor ataxia, gave me a brief but significant history, put
the patient through his paces, and asked for a diagnosis. I hesitated,
blundered through a number of further unnecessary questions, and finally
stumbled upon it. After the patient had left the room, I, feeling rather
proud of myself, expected his commendation, but I didn't get it. "My
boy," he said, "you are not up to the mark yet. You should be able to
recognize a disease like that just as you know the face of an
acquaintance on the street." A positive and full-blown diagnosis of this
sort can, of course, only be made in two or three cases out of ten. But
the method is both logical and scientific, and will give information of
priceless value in ninety-nine cases out of a hundred.

Probably the first, if not the most important, character that catches
the physician's eye when it first falls upon a patient is his
expression. This, of course, is a complex of a number of different
markings, but chiefly determined by certain lines and alterations of
position of the skin of the face, which give to it, as we frequently
hear it expressed, an air of chee