If I were to put the question to this august representative assembly, "What is the most annoying and unpleasant feature of our professional work, from what source spring our most harassing, though comparatively petty cares and our most provoking disappointments?" I think I should have no difficulty in determining even if all spoke at once, that what we may call the financial question in medicine, enjoyed that "bad eminence" more generally than any other which could be suggested. No doubt much of this difficulty and unpleasantness is inherent in the very nature of the process; for this is the point of metamorphosis at which our talent and industry must be coined into their equivalent of hard cash, where our lofty ambitions, noble aims or Utopian schemes for benefiting the race, come into merciless contact with the hard, cold realities of life and the struggle for existence, always at best a