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on his patient, in the earnest, persevering endeavour to remove his disease and preserve his life. Consequently, the talent referred to should be used with much judgment and caution. But I foresee that your habits of discrimination will lead you to doubt whether the example I have supposed really constitute an exception to the rule. It certainly is not foreign to the spirit of the rule, which I think may be thus expressed :—that no attempt should be made by the physician to promote the religious welfare of the sick, which is incompatible with the full, efficient, satisfactory discharge of his medical duties and obligations.
The Second preliminary relates to the distinction which it is important to mark between that general responsibility which, in my humble opinion, requires the physician to be always on the alert to profit by every incidental opportunity of employing his influence for the spiritual good of his patient; and that special obligation which may sometimes devolve upon him (in consequence of the total absence of religious instruction), to attempt, in a more particular manner, to rescue the sinking soul from perdition, and direct it to Him, "who is able to save to the uttermost." This distinction leads me to propose, as a second general rule, that, inasmuch as religious instruction forms a part of ministerial and relative duty, it would be highly inexpedient for the physician to add to his already onerous engagements, that of undertaking the spiritual supervision of his patient, except under circumstances of imperious necessity. Whenever, therefore, the aid of a Christian minister or a pious relation can be obtained, the medical practitioner may, I conceive, regard himself as free from any special obligation of that nature.
These limitations obviously imply that, in by far the greater number of instances, the religious influence of the physician should be exercised in an occasional, rather than in a stated and formal manner. If alive to the spiritual welfare of his patient, such opportunities of usefulness will not be wanting. Perhaps, nothing would so essentially contribute to the furtherance of the object, as the offering up of earnest supplications to the "Father of lights," for His especial guidance and help, before the physician enters upon his daily engagements, that he may be enabled both to discern and improve every suitable opportunity, which even in the ordinary exercise of his profession, may be presented, of doing good to the souls of his patients.
In seeking, and humbly expecting, thus to employ your influence in this sacred cause, I feel the most encouraging persuasion that “ 'your labours will not be in vain in the
It may be convenient to arrange the few thoughts which have occurred to me in reference to the mode of offering "a word in season" in a few leading particulars; premising that, next to the Divine blessing, the secret of usefulness will be found, I humbly anticipate, in the careful, discriminating adaptation of advice to the particular circumstances of the case. Age, sex, degree of intellect and cultivation, particular habits of body and of mind, the actual stage of the disease, the hopes and fears of the patient in relation to futurity, the religious knowledge already possessed, the presence or absence of spiritual instruction, and many other circumstances, will, I am
persuaded, appear to you deserving of special consideration. I can, therefore, only hope to suggest a few general principles, which may be indefinitely modified and applied, according to the varied and ever varying circumstances of each individual case.
My first suggestion has already been anticipated. I refer to the importance of recommending and even urging the assistance of a Christian minister or a pious friend, in cases of serious and dangerous illness. I am aware that the very mention of the subject is sometimes productive of considerable alarm, and certainly requires much prudence and caution. With skilful management, however, the exciting of any injurious degree of apprehension and foreboding may generally, I would hope, be avoided. One may say, for example, in the course of conversation, to a patient apparently unconcerned or uninstructed in reference to Eternity, "You must find the change from active life to the confinement of this room rather irksome. Yet some time for calm reflection is really needful for us all. When withdrawn from busy life, we can look upon the world at a distance, as well as come into closer contact with ourselves. Indeed serious consideration can never be unsuitable. Human life itself is confessedly uncertain, and of course, under disease, still more so. Should you not find a little conversation with a pious minister interesting under your present circumstances?" In this familiar way (pardon its homeliness), one may sometimes introduce the subject without abruptness. From having had much personal illness, I have been able to press the matter further, by assuring the patient that such assistance has repeatedly proved very consolatory
to my own mind; thus, presenting a living instance of the incorrectness of the popular opinion that, to propose the visit of a minister to the sick, is tantamount to a death-warrant.
Should the recommendation prove entirely fruitless; should the unhappy patient, notwithstanding our utmost professional efforts, be so rapidly hastening into eternity as to afford no opportuuity of procuring more efficient spiritual aid, the case will then present one of those special occasions before alluded to, which call for our more immediate and devoted attention, in reference to the immortal spirit. And who, that values his own soul, would not, under such circumstances, endeavour, with all possible earnestness and affection, to exhibit to the dying man the compassionate and Almighty Redeemer, as able to save even at the eleventh hour?
I may next suggest that the allusions of the physician to the subject of religion should generally be incidental and conversational; arising spontaneously from a solicitous regard to the particular situation of the sufferer. When such occasional advice appears naturally to flow from the heart, partaking of the disposition and character of the speaker, and having an evident bearing on the special circumstances of the patient, there will be little risk of its being regarded as superfluous or obtrusive. On the contrary, I believe, it will usually be welcomed as a gratifying proof of disinterested friendship. this incidental way, one may sometimes refer to the experience of great and good men under similar sufferings, and to the signal support vouchsafed to them, and to the happy results of their afflictions. On some occasions, it may be useful to adduce the remarkable fact, that some of the
brightest ornaments of the Church and of the world have ascribed much of their success in life to the discipline they were once called to endure in the chamber of sickness and seclusion.
May I add, that the occasional hints of the physician should also be brief? A single sentence well-timed, welldirected, appropriate, and expressive, will possess the great advantage of not wearying the attention of the sufferer, while it may, notwithstanding, supply ample materials for reflection during the succeeding hours of solitude and silence. "A word spoken in season, how good it is!"
Nor is it less important, I conceive, that such advice be expressed with clearness and simplicity, in a few plain words and short sentences, bearing a direct and obvious meaning, and free from ambiguity and circumlocution.
Allow me also to suggest that the advice should be considerate and kind; the evident effect of genuine sympathy and tender concern. No word should be dropped that might seem to imply an unmindfulness of the suffering, helpless, unresisting state of the patient, or oblige him to attempt a lengthened and laborious reply. One kind sentence delivered in a tone of kindness, and accompanied with a look of kindness, may, and often will, juvante Deo, penetrate the heart.
In certain states of disease, in which high excitement, or extreme debility prevails, it may sometimes be expedient to address a passing hint to a relative or friend who may be present rather than to the patient himself, thus leaving to the option of the latter, whether or not to reply to the observation.
Yet should the hints be faithful. Any approach to tem