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or by recurring in memory to your own feelings when inexperienced, I will venture to give you the first crude impressions which have crossed my own mind.

"Give a few instances of the mode of connecting in an easy and natural manner some serious remark with his medical counsel.' Instances to illustrate this rule would, at once, make it particular and practical. Though one might, by practice, succeed in finding out suitable hints, yet a very few, already approved by your experience, would give confidence, and remove the anxiety attendant on the first attempts. "Introduce a model of a conversation, with texts, for one who is dying-i. e. the special case.

"The attractive and encouraging promises of the gospel might be dilated upon-especially to shew that no other religion-nothing but the gospel, can meet the exigencies of the sinner at the eleventh hour, and that, for him, it is all-sufficient.

"In order to give a word in season,' one must be ready: one must have a little stock always available at a moment's notice. If this readiness is to be acquired by personal experience and reflection only, it will be acquired slowly, and used timidly at first. How much better to be provided with a type from the hand of a master!

"Convalescence. Give specimen of a conversation with a religiously inclined person, and with a worldly one. Show that illness is often sent, in mercy, to awaken, and how delightful to regard it as such.

H

"Recommend books and name a few tracts, and point out their adaptation to a few supposed cases of different ages, ranks, and religious proficiency.

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"Believe me ever, my dear Sir,

"Very sincerely yours,

"J. HOPE."

P.S.-Pray let the junior physician remain incog. He shrinks from publicity, lest he should injure the cause by being found unworthy."

CHAPTER VI.

FEW men have worked harder than Dr. Hope had done up to the period to which we have now brought this memoir. He was, however, frequently heard to say, that laborious as his studies had been, they were but child's play to the exertions he underwent during the next five years of his life, as assistant-physician to St. George's Hospital. What was the amount of those exertions will be best seen from a document which will appear in connexion with the circumstances which led to its being written; but the following fact will prove that Dr. Hope did not over-estimate his own labours.

The medical and surgical staff of St. George's Hospital consisted of eleven persons; and while ten of these saw about one-half of the patients, the other half

fell to Dr. Hope's share*. It may be objected, that this estimate gives a fallacious idea of his real work, because the in-patients which were seen by the other officers, being acute cases, required more time and attention than the out-patients seen by Dr. Hope. This objection is so satisfactorily answered in the document above referred to, that it requires no further

comment.

Dr. Hope had always attached great value to the Marylebone Infirmary as a sphere for the observation of acute disease; and he considered himself no less fortunate in the opportunity now afforded him at St. George's Hospital for treating chronic cases, that class which comprises the greater number likely to occur in private practice. He said, that the duties of the assistant-physician at the latter institution presented an unparalleled field for the scientific observation of the comparative applicability and efficacy of different medicines when given in a great number of cases; of the comparative prevalence of different diseases; of the

*This statement is founded on the following data. A letter from the Secretary's office shews, that the out-patients, during the five years that Dr. Hope was assistant-physician, were 29,842. Of these, upwards of two-thirds were medical, and it may be said, in round numbers, that Dr. Hope saw 20,000 of them. The printed annual report for the year 1837, states the in-patients to have been 2402, which, multiplied by 5, will give a result of 12,010 in-patients during the same period. The total number of patients for the above five years must have been 41,852, of which Dr. Hope saw about 20,000that is, nearly one-half.

circumstances by which they are most easily induced; and of many other facts which are not only very valuable to the private practitioner, but also throw much light on the subject of statistics and public health.

Besides seeing the medical out-patients, which was the only duty necessarily involved in his new appointment, his desire to be on friendly terms with his colleagues, united to his activity of mind, led him to entail on himself the additional fatigue of lecturinga task which it remained at his own option to undertake or decline, and from which several of the other physicians and surgeons kept aloof without incurring the slightest censure. As the public cannot be supposed to understand the constitution, if it may be so called, of the medical and surgical departments of an hospital, the following explanation may not be amiss.

At St. George's, as at most of the other metropolitan hospitals, the services rendered by the physicians and surgeons are gratuitous, so far as regards the governors, not being paid for out of the hospital funds. Instead of a salary, they are permitted to instruct students, each of whom, on admission, pays a fee for liberty to follow the physicians and surgeons in their rounds. These fees are divided among the physicians and surgeons. The assistant-physicians and assistant-surgeons at St. George's are excluded from any share in them, on the plea that their practice in general is not of a character to attract pupils; and their services to the

institution are thus strictly gratuitous. Another source of emolument is open to the medical officers. A medical school is always attached to the hospital, at which lectures are given, and anatomy is taught. Each pupil attending the lectures or the anatomical demonstrations pays a fee, which is the perquisite of the lecturer or demonstrator. Some courses of lectures, as those on the practice of physic, surgery, &c., being attended by all the students, afford a handsome remuneration, while others, as those on botany, forensic medicine, &c., pay so badly as not to compensate a man for his time if it be of any value. They are only kept up to promote the general interests of the school, and are delivered sometimes by the junior physicians and surgeons, sometimes by persons unconnected with the hospital. Besides the foregoing lectures, a certain number of clinical or bed-side lectures are given by those who are best qualified to attract pupils, and for these no remuneration is received. The medical school is quite distinct from the official duties of the hospital, and, as before stated, it is optional with the physicians and surgeons to join it or not.

At the time when Dr. Hope became attached to St. George's, two medical schools were connected with it. The quarrels which had attended the appointment of an assistant-physician and a second assistant-surgeon, had led to the establishment of a new anatomical school, and the most strenuous exertions were made by the greater part of Dr. Hope's colleagues to support it.

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