One of the greatest trials which the physician has to bear is the ingratitude of those upon whom he has conferred favors. There are services rendered by the medical man who is faithful to his high trust, for which no money is an adequate compensation. His reward for such services comes from two sources—the satisfaction always attending the performance of duty, and the gratitude of those to whom they are rendered. The wealthy by no means discharge in full their obligations to the physician, who attends upon them in all their sickness with unwearied fidelity, when they pay him in full for his attendance. They owe to him the affection of a true friendship, and the gratitude due to something more than a professional performance of duty in their behalf. The relation of a physician to his employers is not shut up within the narrow limits of mere pecuniary considerations. There is a sacredness in it, which should forbid its being subjected to the changes incident to the common relations of trade and commerce among men. But many do not so regard it. They dismiss a physician for as slight a reason as governs them in ceasing to buy of one man, and giving their patronage to another, or, as Dr. Rush says, “with as little feeling as they dismiss a servant, or dispose of a family horse.” A mere whim, or caprice, is often suffered to dissolve this relation, though it may have existed for years. And generally the more frivolous and unfounded the reason for the change, the greater will be the zeal with which they laud their new favorite, and the harsher will be the aspersions, which they will cast upon the professional character of the old and tried friend, whom they have deserted. Strange as it may seem, it is the experience of every physician, that some of the strongest evidences of ingratitude come from some of those upon whom he has conferred the highest favors, perhaps those which are entirely gratuitous. One would suppose that they who have had the services of a physician without making him any compensation, would from motives of delicacy refrain from speaking ill of him, if they chose to discharge him and employ another. But blame is sometimes dealt out without stint under such circumstances. It would be supposed also that the obligation, which a gratuitous attendance imposes, would always be gratefully recognized by the patient. But it is often otherwise. Many patients are disposed to forget such obligations; and everything which may call them up to their attention, and especially to the attention of others, is carefully avoided. Dr. Rush speaks of some who had been attended gratuitously in humble life, who deserted their family physician after their elevation to rank and consequence in society, “lest they should be reminded, by an intercourse with him, of their former obscure and dependent situation.”