Early determination ofthe patient’s —since only what has actually been administered will benefit; emphatic assertion is of no use—is beneficial but complicated. For it is through many turns and changes that all diseases settle into some sort of permanence. Because changes and turns are common in the early stages, to fix the proper treatment early is a complicated matter. This piece of advice also will need our consideration, as it contributes somewhat to the whole. For should you begin by discussing fees, you will suggest to the patient either that you will go away and leave him if no agreement be reached, or that you will neglect him and not prescribe any immediate treatment. So one must not be anxious about fixing a fee. For I consider such a worry to be harmful to a troubled patient, particularly if the disease be acute. For the quickness of the disease, offering no opportunity for turning back, I. e. from missed opportunities that have passed away while haggling over fees. It is possible that ἀναστροφή has here the sense of ἀναστρέφειν καρίδαν in Thucydides II. 49, to upset. An acute disease is not the time to upset a patient with financial worries. spurs on the good physician not to seek his profit but rather to lay hold on reputation. Therefore it is better to reproach a patient you have saved than to extort money from Or, if Coray’s emendation be adopted, to tease. those who are at death’s door.