XXvi INTRODUCTION. 



of getting up early in the morning is a most valuable one. You are fresh, and are 

 quite sure to be free from interruption. In summer it is very enjoyable, and even 

 in winter one soon gets used to it. It is just as easy to get up at four or five as it 

 is at half-past eight. Some people display considerable anxiety to have the world 

 properly aired before they abandon the welcome refuge of the bed-clothes, but when 

 a man has work to do the sooner he sets about it the better. Barristers, statesmen, 

 doctors, litterateurs, and theologians often suffer most frightfully from the effects of 

 over- work. Too frequently a man cannot give up a part of his work without giving 

 up the whole of it. He must either do it or throw it up entirely. Sometimes, 

 however, little modifications in the details of work will afford considerable relief. 

 Sometimes a man may be able to sleep out of town, even if he cannot do anything 

 else. Or why should not he take his books, or his picture, or whatever it may be, 

 down to the river and work there for a month or two % Even when this cannot be 

 done, some assistance might possibly be obtained in the more mechanical parts of his 

 work. Why should he not get some one to read to him instead of reading himself 1 

 Or why should he not get some one to write his letters and papers from dictation 

 id of wielding the pen with his own hand? One of our most accomplished 

 novelists dictated some of his finest passages before getting up in the morning. A 

 good shorthand writer is in many of these cases an invaluable aid. Of course this 

 involves a certain pecuniary expenditure, but Avhen people have so much to do their 

 incomes are usually proportionately large. 



This, then, concludes our account of the causation of disease, and we now proceed 

 to the consideration of what we call ''symptoms." This is a term which is in 

 constant use, and one which hardly requires explanation. A simple example will 

 serve to illustrate its meaning. A man gets an attack of rheumatic fever, and we 

 say that his chief symptoms are high temperature, quick pulse, thirst, loss of 

 appetite, profuse perspiration, and pain, swelling, and redness of the joints. These 

 are, of course, parts of the disease, but we call them symptoms, because it is by their 

 occurrence that we are enabled to recognise the nature of the disorder from which 

 the patient is suffering. We sometimes speak of "premonitory" symptoms, by 

 which we mean the earlier symptoms of a disease which indicate that the patient is 

 ill, but are not sufficiently characteristic to point out the nature of the complaint. 

 For instance, a child may be suddenly seized with shivering or vomiting, and on 

 examination he may be found to be very feverish. Now these symptoms are pre- 

 monitory of many diseases, and all we can say is that the child is "ailing for 

 something," and that it is probably going to have scarlet-fever or measles, or some 

 other acute illness. 



Then, iixiiii, we talk of " subjective " and " objective " symptoms. A subjective 

 symptom is one that the patient communicates to the doctor, whilst an objective 

 symptom is <mo that the doctor can tiud out for himself. For instance, a patient 

 says that he suffers from palpitation and pain in the left side, these are subjective 

 symptoms, but if the doctor listens to the chest, and finds that the heart is beating 

 irregularly, or that the sounds are not clear, these are objective symptoms. Doctors, 

 as a rule, prefer forming an opinion as to the nature of an illness on objective 

 symptoms rather than on subjective. In many hospitals, more particularly those 



