morbid, scared, obstinate child-man?
You put aside his questions, but you have here a person quite or nearly
sane to-day, resolute to hear, afraid to learn the truth he dreads. I
leave my reader with this patient, and my stated knowledge and my
shifted responsibility. "Doctor, if I am going to be insane, I will kill
myself." Good reader, pray dispose of this case. Or take the ease of a
confirmed hypochondriac. He is miserable, has a hundred ailments,
watches the weather, studies the barometer, has queer delusions as to
diets, clothes, and his own inability to walk. The least hint of a
belief that he is not as well as he was a week ago, or even a too close
examination, leaves him with a new malady, and he, too, is a sharp
questioner. As a rule, he has no perceptible changes in his tissues. But
if he has some real malady,--it may be a grave one on which he has built
a larger sense of misery than there was need for, and the case is common
enough,--how shall you answer him? It is a less difficult case than the
other, and I gladly leave him also to my consultant reader's acquired
knowledge and to his personal sense of the value of truth.

Physicians are often blamed for not sooner warning a family of the fact
that, in some case he and it are anxiously watching, death is
inevitable. As to this the doctor has very mingled feelings. Sometimes
he lacks courage, sometimes he is not sure enough to speak. A weak man
fears that he will lose his patient and some quack be called in, and
thus lessen the little chance yet left. Most of us can recall painful
interviews in which a relative insisted on a definite opinion, which we
were unable to give. As to cases where there is little or no doubt left,
perfect frankness should be, and is, I think, our rule, but no one knows
better, or as well as we, how numberless are the chances of escape for
cases which seem to be at their worst. Hence a part of the reluctance
the physician has to pronounce a verdict of fatal character.

There is another matter of moment as to cases known to be hastening to a
fatal conclusion. The responsibility of withholding this knowledge from
the patient is usually shifted on to the shoulders of relatives or
friends. The medical adviser reports to them his opinion and leaves with
them the power to act.

He is often asked if to know that death seems certain makes less the
chance of recovery or shortens the lessening number of the days of life
yet left. It has often