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A practitioner of medicine in a large city, as a rule, has not as intimate a knowledge of his patients and patrons as his confrère in the small country town of two or three thousand inhabitants. In the cities, unless it be an exceptional case, the statement of the patient must be accepted as our basis upon which to draw conclusions; but in the smaller towns, nearly every one is personally known to the physician, who may have had, in a long life, a personal knowledge of three generations. It has been my own experience in several cases to have had a knowledge of as many as four generations of several of the families for whom I have practiced, and in cases referred to in the subsequent portions of this article, frequently three generations have been my intimate acquaintances. It is just such a condition as this that will make
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T. J. Happel (1900) studied this question.
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