Dr. Theodor Puschmann, in his "History of Medical Education," quotes an old writer[213:1] who inveighed against those practitioners who were wont to fill the ears of their patients with stories of their own professional skill, while depreciating the services of others of the fraternity. Such unscrupulous quacks sought also to win over the patient's friends by little attentions, flatteries and innuendoes. Many, said this philosopher, recoil from a man of skill even, if he is a braggart. "When the doctor," he continues, "attended by a man known to the patient, and having a right of entry into the house, advances into the dwelling of the sick man, he should make his appearance in good clothes, with an inclination of the head; he should be thoughtful and of good bearing, and observe all possible respect. So soon as he is within, word, thought and attention should be given to nothing else but the examination of the patient, and whatever else appertains to the case." In England, during the earliest times, the administration of medicines was always attended with religious ceremonial, such as the repetition of a psalm. These observances however were often tinctured with a good deal of heathenism, the traditional folk-lore of the country, in the form of charms, magic and starcraft. It is evident, wrote the author of "Social England,"[214:1] from the cases preserved by monkish chronicles, that the element of hysteria was prominent in the maladies of the Middle Ages, and that these affections were therefore peculiarly susceptible to psychic treatment. The Angles and Saxons brought with them to England a belief in medicinal runes and healing spells, and the cures wrought by their medical men were attributed to the magic potency of the charms employed. Some interesting information on contemporary manners is contained in a "Book of Counsels to Young Practitioners" (A. D. 1300). The use of polysyllabic and unintelligible words is therein recommended, probably as a goad to the patient's imagination. Medical charms, wrote a shrewd philosopher of old, are not to be used because they can effect any change, _but because they bring the patient into a better frame of mind_.[215:1]