After a full-fledged attack on modern society, holding aloft the banner of civilization, Miss Manners always feels a tad peaked. The Mayo Clinic arrived just in time.

This particular exertion was Miss Manners' attack on the unauthorized use of first names in impersonal situations, as, for example, by doctors and nurses who have the mistaken notion that this makes patients feel better.

Actually, as Miss Manners keeps stating, and her Gentle Readers testify by every mail, it makes them feel worse. Stripped of their clothes, people are particularly sensitive about also being stripped of their formal dignity.

"I know that some people advocate a use of first names, hoping to convey friendliness to patients," writes the personnel director of the Mayo Clinic, Herbert L. Howe.

"It seems to me this creates an unnatural situation -- after all, people come to Mayo for professional medical treatment, not for a social occasion."

The Mayo "policy of courtesy" is specifically intended, he writes, "to put people at ease. Many patients can feel apprehensive over the technology and complex procedures that are part of a large medical center. Treatment can be enhanced when patients are in a confident frame of mind."

But rather than consisting of pseudo-friendship, Mayo policy calls for addressing patients by title and surname, as well as "using a warm tone of voice, taking the time to answer questions, and performing tasks of practical value to a patient."

Miss Manners feels better already. At last someone understands that courtesy and chumminess are not synonymous, and that it is silly to imagine a state of friendship in which one friend has his clothes on and the other doesn't. If both of them . . . no, never mind.

What Miss Manners meant to say was that she has nothing against friendliness. On the contrary, some of her best friends are friends.

But friendship is a voluntary social bond, not to be confused with the merely pleasant, cheerful, cooperative manner that we all display at all times to all our fellow creatures, regardless of how we feel or how we feel about them.

Among strangers, acquaintances and business associates, such a demeanor is intended to be a superficial disguise, rather than a way of revealing character.

You do not really want to know how the tired clerk or the harried customer feels about life or about you. Rather, you want to feel secure that no matter how he or she feels, you will be treated agreeably.

The Mayo Clinic's policy requires its people to treat all patients with consideration, not just the ones they happen to like or the ones that happen to be there when they feel in a considerate mood.

To use the manners of friendship -- intimate terms of address, kisses, curiosity, personal conversation -- without the emotions is misleading and offensive. No respectable job requires an employe to simulate personal emotions, but all of them should require civility.

Friendship is something deeper, which is why you are allowed to choose your friends, and to work out with them special patterns of behavior for different moods. And even jolly, caring people, overflowing with love of their fellow creatures, do not want to be friendly with everyone, all the time.

They may want to get things done without the duties that friendship entails. They want to eat lunch, rather than listen to the life story of the waiter, or serve it without listening to the accumulated troubles of the customer.

They may want to reserve certain gestures and privileges as special marks of intimacy. Just because your parents call you Bunny doesn't mean that the mail carrier can. Your best friend may be allowed to ask how your love life is going, but that doesn't mean your boss can, or the person sitting next to you in the airplane.

And they may want to feel that being ill, disrobed and possibly frightened does not rob them of being perceived as adults worthy of respect, and still in command of the option of bestowing or withholding their friendship.

Q: At a high school reunion party, while guests were viewing slides of past glories, we heard a loud crash from the bathroom. A young lady emerged, red-faced.

The hostess then announced that she had booby-trapped the medicine cabinet by placing several hundred marbles inside, in case any of her guests decided to snoop. Is it horribly unmannerly to look in a medicine cabinet for an aspirin or a Band-Aid, rather than disturbing a hostess who is entertaining 40 guests? Is it thoughtful for a hostess to leave items such as these in plain view for guests?

A: Towels, soap and tissues are the only required items in a guest bathroom. Extra supplies, including not only first-aid items but hairpins and sewing materials, are thoughtful additions.

But one is not required to run a pharmacy, nor to allow guests to rummage around. Suppose the young lady had torn her stockings -- could she have gone through her hostess' bureau looking for replacements?

Nevertheless, this hostess committed a terrible rudeness. She has a right to store her marbles in her medicine cabinet, but not, when she catches a victim, to explain why. Miss Manners assures her that the lesson has been learned, and she could afford to say graciously, "Oh, dear, I'd forgotten that's where I store my marble collection."

Q: Please advise me on the appropriate amount of time to spend in my kitchen cleaning up after a dinner, while my guests, usually one or two couples, are still here.

Obviously some amount of cleanup is permissible, since it seems appropriate to clear the table and put away perishable foods. My husband feels it is rude to rinse dishes and load and run the dishwasher before the guests have left.

I feel, however, that 15 or 20 minutes in the kitchen does wonders in allowing me to get a head start on the cleanup, and thus enjoy the evening more. I would soak the silverware, which must later be washed and dried by hand, and run a load of dishes. It usually takes two loads to clean up after my dinners.

I normally go to bed between 9:30 and 10, and have to get up several times during the night to feed my baby. Since guests usually depart well past my bedtime, I find that staying up until midnight or 1 a.m. to clean up is more than I can handle. Having visitors this way is far too stressful an event. Please consider that I have no domestic help, and I wouldn't do this if I felt my guests weren't being adequately entertained by my husband and by one another. My dishwasher is reasonably quiet. My husband helps with the cleanup after the guests leave, but it still takes a long time.

A: Miss Manners does not normally deal in what she believes are known as household hints. Nor does she question people about matters on which they have not consulted her.

But just this once, if she promises first to solve your problem by doing the former, may she also do the latter?

Your husband is correct that it is rude to spend 15 or 20 minutes in the kitchen after dinner, thus making it clear to your guests that you are laboring on their behalf while they are relaxing. But you can do as much work inconspicuously if you do it between courses.

As you clear the table, take each dish directly to the sink for whatever rinsing you do (Miss Manners refuses to inject herself into the fight between people who put their dishes into the dishwasher clean, and those who put them in dirty) and put them directly into the dishwasher without ever parking them on a counter top. If you want to soak the silver, have a small tub of soapy water ready in the basin, and dump it right in.

The machine will be full before the meal is ended, and all you have to do is put in the soap and push the button. Should anyone inquire during dessert about that whooshing sound coming from the kitchen, explain that you live near the ocean. For some reason, nobody, even in landlocked states, seems to notice anything wrong with that statement.

Now for the matter that is none of Miss Manners' business:

A baby who regularly wakes up several times during the night is either newborn or ill. Why are you choosing this time to give dinner parties?

Q: I just received in the mail the gift my husband and I gave my parents for their 25th anniversary. My mother had returned it with a polite note saying that they didn't like it.

It was, I admit, an unusual gift -- a large, expensive art book -- but my parents have never been the kind of people who would want a bread tray engraved with their anniversary dates.

I am, needless to say, a little taken aback.

What do I do now? Do I keep the book, although it makes me uncomfortable to see it now? Do I donate it to the library? Do I send my parents another gift? A check, perhaps? A donation to a charitable organization?

Was it a terribly inappropriate gift to begin with?

A: Miss Manners knows of no possible polite way for parents to tell their child they do not like her anniversary present. Unless the present had been something one could interpret as an insult -- a vulgar joke, for example -- there can be no provocation for behaving in this fashion.

This leads Miss Manners to suppose that this is not an isolated difficulty in an otherwise harmonious relationship. The action sounds to her like a wild shot in a long battle.

Nevertheless, politeness requires only that you say tersely that you are sorry your present did not please them. You may do with it what you like, but you need not provide a substitute.

Haven't they already made it clear that your taste does not please them? There is no reason to suppose they would like your taste in, say, money, any better.