unknown. The young physician, much embarrassed, was
civilly asked to examine the case, and did so with a thoroughness which
rather wearied the two older men. When they retired to an adjoining
room, he was asked, as our custom is, to give, as the youngest, the
first opinion. He said, "It is a case of epilepsy. He has bitten his
cheek in the fit." Dr. P. rose without a word and went out. Returning in
a few moments, he said, "You are right. I did not look far enough back.
You will reach, sir, a high rank in our profession." The case was
thenceforward plain enough. These are rare illustrations of my meaning,
and may suffice, with one which has a more humorous aspect. Meeting the
late Professor C. D. M. on the steps of a house where, the day before,
we had seen together a woman critically ill, he said to me, "Mrs. B. is
better, doctor, much better." "And how do you know that?" I returned.
"Her windows are open, my dear doctor. She wants more light. She must be
better, much better." And so she was, as it proved.

A final result of the multiplication of the means of research, and the
increasing difficulty in becoming expert in the use of the many and
delicate instruments they require, is the growth of what we call
specialties in medicine. The best of us learn to use the ophthalmoscope
to look into the eye, to use the laryngoscope for the larynx, and can at
need examine the urine and the blood, but the men must be rare who are
as competent to use each and all of these means as persons who devote
themselves to single branches of our work. Moreover, the element of time
comes in, as well as the element of such constant familiar practice as
makes for one man commonplace and easy what for another, who is more
generally occupied, is uncommon and unfamiliar. The specialist profits
by the fact that his experience becomes enormous and his work advantaged
by its definite limitations. On the other hand, and nowadays especially,
he is too apt to be one who, after brief hospital work of general
character, or without this, takes up, as we say, the eye, ear, throat,
or uterine organs. Unless he has had at some time a larger and more
varied experience, or unless he is a most unusual man, he is prone at
last to lose sight in his practice of the fact that eye, ear, and womb
are parts of a complicated mechanism, and suffer through its general or
local disorders. Hence the too common neglect of constitutional
conditions, to which are often due the