teract, but augment each other. If the argument from interference be "for isopathy and not at all for homœopathy," because interference relates to identical forces, then the identical forces should exhibit the phenomena of interference, which, as just observed in the case of medicine, we see that they do not. Does not the dissimilarity of effect suggest that the causal forces, called identical, are in reality similar forces? That the forces which evoke the phenomena of interference are not scientifically identical, but similar, can be clearly shown. The forces inherent to substances which exhibit the phenomena of interference may appear to be as truly identical as their names are, but, regarded as specifically related forces, they will be seen to be similars. Strictly identical forces must be identical in all respects; in which case they become one. If two streams of force from the same kind of substance be merely differentiated as positive and negative, they are no longer identical forces, but are necessarily similar.

From the editorial of the Homeopathic World, of the current month, here is a small extract which is peculiarly apropos; "In his History and Heroes of the Art of Medicine,' Dr. Rutherford Russell gives a story of Galen's art, which bears on this. The philosoper Eudemius had brought on an illness by the excessive use of theriacum. Galen cured him by giving small doses of the very same medicine! This is analogous to the cure of coarse drug effects by the same drug in high potencies. It may be isopathy rather than homoeopathy; but it is by no means easy to draw a sharp line between the two." As "rough examples of possibilities of cure on the like-to-like principle," in the same article are mentioned "powdered snakes for snake-bite, 'a hair of the dog that bit him' for hydrophobia, and altered virus of consumption for consumptives." To which may be here appended our own classical illustrations of similia in the cure of frost-bite by application of snow-water or friction with snow, the cure of burns by the identical fire which caused the injury, the cure of bruises and the like by further gentle bruising, etc.

The varied phenomena which are superficially classified under the terminology of homoeopathy and isopathy all occur under the same dual law. Homoeopathy has regard, particularly, to quality, and isopathy to quantity, in the relationship of forces directed to therapeutic ends.

The semi-circle of law denoted by homoeopathy is similarity of quality; the complementary semi-circle of law denoted by isopathy is equality of quantity; and the science of medical therapeutics is adequately represented only by the complete

circle.

In conclusion, allow me to say that on page 25 of the brochure

under review may be found an indication of the real nature and relation of homoeopathy and isopathy, as regarded by the writer; and that it is his intention, as circumstances favor him, to develop fully the indications referred to, with others of equal practical interest that are scattered through the essay which you have so generously reviewed.

A CASE OF SUPRA - PUBIC LITHOTOMY.

BY W. K. BOUTON, M. D., MELBOURNE, AUSTRALIA.

On the eleventh of December, 1891, J. D. was admitted to the Melbourne Homœopathic Hospital. He was in his 70th year, and for a long time had been practically helpless and confined to his bed. His chief trouble for some years had been · called rheumatic gout, and treated as such. A history of urinary difficulty dates back fifteen or twenty years, but so far as could be learned, stone in the bladder was not diagnosed up to December, when the present writing commences.

Patient complained of dragging pain before passing urine. At times there was incontinence. There were, also, both pus and albumen in the urine. His heart's action was very irregular and intermittent. He had of late become almost silly in conversation and action - decided mental aberration. Wanting to escape, but unable to do so. When spoken to, at times answers reasonably but soon wanders off in disconnected talk and ideas, mixes present and past dates and circumstances surrounding them. On passing a sound into the bladder it was seen that the condition was certainly unusual, and it was explained to the friends that, considering his age and state of health, an operation was a very serious matter; but they were very anxious to have something done, and remarked, "That he was better dead than as he was." Consequently, on Dec. 15th, bearing in mind. the size and quantity of the stone, I decided to perform the supra-pubic operation. I may here say that no antiseptic conditions were observed, further than a rigid use of soap and water, which is the usual procedure with me in all operations. Ether was administered, a rectal bag was used, into which eight ounces of water was injected. The bladder, likewise, was filled with twelve ounces. An incision three inches long was made close down to the pubic bone; when the bladder presented in the opening a needle with stout silk was passed through to prevent the walls collapsing, and the incision carried through into the bladder. A pair of forceps was used to grasp the first stone, but it was crushed in the effort to extract it. In consequence I subsequently used two fingers, and removed in all six stones, the broken one being in many pieces. The bladder was then

flushed out until the water ran clear, a catheter tied in the urethra, and a drainage-tube put into the wound. The following day patient was taking nourishment well; temperature, 100°. The penis and scrotum very oedematous and swollen. Water was injected through the catheter until it came through tube quite clear, tube then removed, but catheter left in place. The second day, much the same; again bladder washed out, the catheter then removed. On the 24th, nine days after operation, the patient was troubled all day with involuntary liquid, scanty, dark stools; but this was only a temporary difficulty, for from this time all went well. On the thirteenth day, the wound had closed, and on the 4th of January, or twenty days after the operation, he was allowed to leave his bed and go about, a thing he had been unable to do for months. Ten days later he was discharged from the Hospital, cured. The mental symptoms had entirely cleared up, he ate and slept well, had no difficulty whatever with the bladder or contents; and, whereas, the old man had been practically helpless for years from rheumatic gout and other complaints, since recovery from the operation has been able to get about comfortably, and enjoys the usual degree of health for a man of his years.

The stones, as shown in the cut, are six in number, combined urates and phosphates. Four of them are avoid in shape, the other two irregular. The one marked 2, is the largest, 1 inches in diameter and of an inch thick; weight, 1 ounce. Total weight of the six, 3 ounces. The one marked 5, which was crushed by the forceps, is in size and weight about equal to number 3.

It is now five months since the operation, the patient takes long walks, and, to use his own words, he "couldn't wish to feel better."

MEDICAL EDUCATION. THE HOSPITAL SHOULD PRECEDE THE COLLEGE.

BY F. H. ORME, M. D., ATLANTA, GA.

[Read before the American Institute of Homœopathy.]

Prof. I. T. Talbot, in his excellent address before the International Homœopathic Congress, in summarizing the absolute requsites of a medical college suitable to the present time, includes "A hospital with at least one hundred and fifty beds,' and "A dispensary capable of treating ten thousand patients annually." To emphasize the importance of these requirements is the purpose of this paper.

It would seem to be a work of supererogation to urge the importance of the hospital and the dispensary or clinic in the acquirement of an education for the practitioner. Such argument is surely not needed by those who are familiar with the advantage of these unequalled means of imparting instruction. Who, indeed, would gainsay or question them? It is well, however, to be reminded of what we know; and, as there are factors at work which tend fo minify the importance of these advantages, it is worth while to keep attention well directed to the subject.

The time was, within the memory of at least the Seniors of this body, when such requirements would have been excessive and unreasonable; but in all departments of learning, and in the progress of civilization generally, there has been such advancement that these exactions are not only reasonable but are positively demanded.

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In what might be likened to the "Stone Age" in medicine, when men were their own physicians, seeking, as do the lower animals, what they were guided to by inclination or instincts— often to their ruin (there is no greater fallacy than that instinct is unerring), there were, of course, no restrictions upon what a man chose to do for himself or his family. Students and self-constituted doctors were compelled to pick up knowledge as best they could — a little here and a little there — and little, indeed, and seriously questionable in quality it generally was.

As civilization progressed, a period corresponding to the "Age of Bronze" was reached, when the art of dealing with the sick was specialized and centered in certain individuals. These were properly regarded as having peculiar qualifications for their vocation, and a pupilage under one of these, with a certificate of proficiency from the tutor, was the only warrant that could, with any show of reason, be looked for or required.

Later came the "Iron Age," with the formation of schools or colleges of doctors, who, in a lecturing way, taught some of the

knowledge that had been acquired from practice by themselves and others. These continued on, increasing their facilities, adding thereto illustrations and demonstrations until the best institutions but only the best were provided with opportunities for exhibiting cases of disease, with their treatment.

Now, however, in this glorious "Age of Steel" (not as exemplified by the lancet, which has had considerable rest) with the golden illuminations of Hahnemann, still better things may be expected; and with the present facilities of transportation, no one who should aspire to the profession can complain if compelled to attend a college where the proper opportunities for acquiring a thorough medical education can be furnished. The argument that some poor but worthy and ambitious young man. may wish to engage in the profession, who must content himself with inferior advantages, is met with the fact that he is not the only or the principal party to be considered. The good of the general community comes first. If one be not fortunate enough to be able to secure the best education, modesty, to say nothing of generosity and justice, requires that he should adopt some pursuit within his reach, while those who are able may prepare themselves properly for the responsible office of taking the care of human life in hand.

It is the just pride of our Institute that it leads the van in the effort to elevate the standard of medical education. Not one of the sixteen homoeopathic medical colleges which have representation in this body- not a homoeopathic college in the United States but makes the three years' graded course compulsory thus being in the lead of other schools - and a four years' course of study is demanded of all who expect to receive a diploma from an homoeopathic college. This is surely a creditable distinction. Let others follow the commendable example! Without detracting from the importance and especially the past service of oral teaching, it must now be admitted that in medical didactics, the clinical demonstrations - the object lessons are of the first rank. The principles, the science of medicine, with something of the results of different modes of treatment, may be taught in the ordinary didatic way; but the college that wishes to send out men qualified as they should be at this day, must be provided with ample hospital and clinical advantages for it is through these that the art of practice is to be acquired, and without these there is no thorough preparation for the responsible duties of the practitioner.

Physiognomical presentations impress and inform the student or the physician more than any form of verbal description can possibly do. In the presence of disease we are instructed without words: we learn from the patient more than from the pro