It is infinitely more difficult for a medical practitioner to urge necessary but unpopular reforms than it is for any other professional person to do so. The physician believes that he can succeed only by raising no prejudice against himself. He is always tempted to be neutral, when partizanship may seem likely to imperil his interests. There are no safe prizes to be won in the one profession which every one allows to be beneficent, whatever may be thought of other professions. By a code of honour which is rigidly adhered to, the process of a physician's treatment cannot be kept to himself. By an equally rigid rule, the confidences reposed in him are as sacred as the secrets of the confessional. It is no easy matter to win position and fortune in a calling which is regulated by the strictest rules of professional honour. It seems easy to imperil the most carefully acquired reputation by running counter to obstinacy and prejudice. A medical man has every motive to avoid hostile criticism. If he determines on doing that which is unpopular, the risks which he runs are far greater than those of any other person. Now all this was encountered by my brother's action, and he never was allowed to forget that he had to encounter it. He had to reckon with sordid London vestrymen, perhaps the worst class of men with whom honest people have to deal, and with the officials of the Poor Law Board, who were determined, as far as possible, with rare exceptions, to shirk all responsibility. In the pages of this volume he shows plainly what were the obstacles to his endeavours. As might be expected from an honest man, who never counted the odds against him when he was convinced that he was in the right, his original manuscript commented, with no little indignation, on the persons who thwarted his efforts, and would have baffled his ends. But it is entirely superfluous to stigmatize such people; and I have excised these just but unnecessary judgments. It is sufficient that the reappearance of such persons has been made improbable, if not impossible.