=Undiagnosed Cases.= In the matter of suspected or undiagnosed cases, there is greater difficulty. In these cases the nurse has nothing to go on but her own keen observation of symptoms, therefore the physician in charge may make it very difficult for her to continue her visits. He can withhold his diagnosis, ignorantly or wilfully, and there is nothing to do but to accept this state of affairs. As before, the nurse must quietly hold on to the case, saying nothing that can possibly imply criticism or involve her in difficulty with the doctor. Time must be trusted to clear the situation—either the patient will get better, or he will get so much worse that a diagnosis may be forthcoming. Or else he may change doctors. When a nurse is visiting a case in charge of one doctor, she must be exceedingly careful never to advise another or to suggest a dispensary. All this involves infinite waste of time and loss of life, but as matters stand to-day, there is no other course to pursue. When a nurse is visiting a case of this kind—it may be one who presents every symptom of tuberculosis, including even hemorrhage—she must be particularly careful. She may call up the doctor, tell him that she has been called to his case through such and such an agency (these cases are usually referred by a layman) and ask if there are any orders he would like carried out. She may also ask him to tell her the nature of the disease. If he refuses, it is then a question of further “watchful waiting.” If the patient is expectorating a great deal, she may provide him with a sputum cup and other supplies, taking care, however, never to use the word “tuberculosis” in connection with them. She simply offers them as a convenience for a distressing symptom. We have known patients of this kind who died after being ill for months, most of the time being spent in bed. Meanwhile, they had extreme emaciation, night sweats, fever, cough, profuse expectoration, even hemoptysis, yet the death certificate read “bronchitis.” It is true, that these patients may really have died of bronchitis; as nurses, we cannot make diagnoses, therefore we have no right to question the physician’s findings. But it is impossible for an intelligent nurse to look on at a case of this kind without wishing it were possible to obtain a second opinion. As public health nurses we cannot but object that the last word on so serious a disease should be said by men whose diagnoses we distrust. That the health of the community should be endangered by even a few physicians of this sort,—either ignorant, or dishonest, or both,—is grave commentary upon the medical ethics of the day. It is a severe criticism on that “professional courtesy” which forbids intervention, even by the health authorities, with a physician who drives his trade at the community’s expense. The war against tuberculosis cannot be fought to a successful finish until the public refuses to countenance ethics of this sort.