when the guests to be honored are so universally respected and beloved as are these.

The Gazette can voice its feelings best by repeating a verse from a quotation by Dr. Lapham:

"Health to enjoy the blessings sent

From Heaven; a mind unclouded, strong;

A cheerful heart; a wise content;

An honored age; and song."

THE TRANSIENT AND PERMANENT IN MEDICINE.

BY MAURICE WORCESTER TURNER, M.D., BROOKLINE, MASS.

While both transient and permanent elements obtain in every science, yet those in the latter group have in many cases, in recent years, become more and more subject to change, paradoxical though it may seem, so that many are now properly classed as active elements in the transient group.

It is inevitable if the science be a living, growing one, that changes should occur, and in no living science is this more marked than in medicine.

This tendency to change extends throughout scientific medicine, so called, as those conversant with practice, in the last twenty-five years will readily acknowledge.

This is eminently true in surgery and needs no comment; in regard to the various departments of general medicine, comprised in the term pathology, it requires but slight effort to recall the changes and evidences of growth taking place. In nosology a constant rearrangement is going on, resulting from new divisions based upon bacterial or other modern diagnostic tests. The same is true with etiology, in which there is a steady readjustment with corresponding and necessary changes in symptomatology. In diagnosis the modern aids which supplement the classic signs are being added to each day, all making the decision as to prognosis more definite.

And lastly we come to therapeutics, including, of course, the study of those substances used in practice, i. e., materia medica.

Just here a curious thing is to be noted: while in other departments such change as I have briefly outlined is evidence of growth, and hence to be hoped for and encouraged, yet if it obtain in pharmacodynamics, therapeutic nihilism results. This is evident from and explains the lack of medicinal treatment in allopathic practice today.

Therefore, it seems clear that while certain parts of medical science may change and grow with profit, the vital elements, if I

may so call them, i. e., those having direct relation to the cure of diseases by drugs, should be fixed on a firm and unchanging basis, for while the department of materia medica must be and is capable of endogenous extension, it should not be subject to fundamental nor outside change if confidence in the efficiency of medicines is to be preserved.

It is needless to say that such a condition of therapeutic permanence exists only in homeopathy, and while all things else in medicine change homoeopathic materia medica and therapeutics do not.

Unfortunately this fact, for fact it is, is unrecognized by some and ignored by others. Unrecognized by those who have always antagonized homoeopathy, though often they do not hesitate to make use of it, without giving credit, as far as a superficial knowledge of it permits, and ignored by those who presumably educated in homeopathy prefer the far easier practice of eclecticism or even allopathy.

But by far the most serious result of the failure to recognize the importance of the unchangeable elements in homoeopathy, and one which affects the future, occurs in our medical schools. There the teaching generally ranks homoeopathy "as a method." not emphasizing the value of this solid therapeutic foundation to the specialist and to the physician in general practice, but putting it aside and giving preference to the mutable belief of the hour, thus divesting the future of the hope of trained practitioners of Hahnemannian homoeopathy.

It is just here that both our weakness and our strength lies, weakness that this unchanging therapeutic law is not taught to its logical extent and exemplified clinically, for, from the standpoint of homoeopathy, it is the most important subject. in the curriculum. The ideal way to teach it would be to unite the chairs of materia medica and practice, including homœopathic philosophy, and give this consolidated chair not only hearty support, but also preeminence over all others; the instruction to be given by those who believe in and are able to demonstrate the truths of homoeopathy in practice.

The truths of homeopathy being the largest asset we have, should be imparted honestly, and with strict adherence to Hahnemann's teaching, otherwise we are recreant to our trust.

As no one would be intrusted with the chair of surgery who was not a competent surgeon, so no one should be given the task of teaching materia medica,-not eclectic nor pseudo allopathic materia medica but homeopathic materia medica, homœopathic therapeutics, and homoeopathic philosophy, whose ability had not been demonstrated, and whose belief in the homeopathy of Hahnemann was not genuine and well grounded.

The teaching of homoeopathy and homoeopathic materia medica so arranged, would constitute the greatest bulwark against empiricism, and also the greatest hope for the future in

medicine, for homeopathy is not dead, nor out of date, neither is it a thing to be ashamed of, nor is its work done.

Homœopathic philosophy, homeopathic materia medica, homœopathic therapeutics, the homoeopathy of Hahnemann, theoretic and applied, is the strength of the school, the only reason for its existence.

If taught honestly, fearlessly, the future of the homœopathic school is assured; but if taught half-heartedly, apologetically, there can be but one ending.

To quote from Constantine Hering: "If our school ever gives up the strict inductive method of Hahnemann, it deserves to be mentioned only as a caricature in the history of medicine."

CLINICAL DEPARTMENT.

CONDUCTED BY A. H. RING, M.D.

Case III.

Diagnosis:

Blepheritis Marginalis caused by two diopters of far sight and a slight degree of astigmatism.

Blepheritis Marginalis, as its name implies, is an inflammation of the margin of the eyelid. It varies in extent from a slight scaliness or scurvy condition of the lid edge to an intense inflammation with an accumulation of yellowish, sticky secretion which agglutinates the roots of the lashes, forming numerous small tufts, or we may have a thickening and erosion of the lid edge with a partial or complete loss of the cilia. It is rarely, if ever, a primary affection. The most frequent cause is some abnormality in the size of the eyeball producing near or far sight, or some irregularity in the curvature of the cornea with its resultant astigmatism. Catarrhal conditions of the nasal passages may be the exciting cause. In these cases there is a dry, congested nasal mucous membrane with a red, irritated or excoriated condition of the edge of the anterior nares. A fair proportion of the cases develop in scrofulous children. Occasionally we find a case which has resisted all treatment. A number of such cases give a history of some form of skin trouble in early life, probably an eczema. In regard to refractive errors I cannot too strongly emphasize the fact that a patient may have a high degree and still possess normal visual activity.

The treatment is the correction of any refractive error. Attention to hygiene and dietetics. The local use of a solution of boric acid and the application of Unguent Hydragerum flavus 1 per cent. to the lid edges. The remedies most frequently indicated are graphites, sulphur, the calcarias, petroleum, hepar, arsenicum, antimonium crudum, and pulsatilla.

Case IV for Diagnosis:

Miss E. S. Age 22 years, single. Occupation, pupil nurse. Born and grew up in a water-front town in Maine. Family history negative.

The patient has always been a well girl, thin, wiry, active. No previous illness of importance: No accidents, injuries, or operation. At onset of illness had been training for nursing about three months, and was at the time having the special care of an advanced case of tuberculosis. Two weeks before giving up she had diarrhea, lasting a week. Then followed a week when the bowels moved normally, but she had headache and chilliness. The next week the headache became severe and tempera

ture, then taken for the first time, was 102°F. The patient was put to bed and remained there five weeks, during which time the pulse and temperature ran the following course:

The headache was the symptom most complained of and persisted for two weeks. There was no vomiting; digestion cared for liquid food well, but the bowels were stubbornly constipated. Physical examination of the lungs and heart negative. Abdomen somewhat retracted, and at the end of a week in bed showed some red spots. Urine was concentrated and high colored but otherwise normal. The bloodWhat was the diagnosis?

The Case of Miss Liu Lan-yii:

Dr. N. S. Hopkins, who, after twenty-five years of work in the missions and medical schools of China, is home on a year's leave, kindly gives us the following interesting description of medicine as practised by the native Chinese physician:

Miss Liu Lan-yii had been ill for a long time. Many domestic remedies had been tried and suggestions from the friends of the family had been carried out, but they were of no avail. Last spring, while suffering from daily rise of temperature, she had, at three different times, taken a half cup of tadpoles, but the coldness of these did not reduce it save for a time. Later in the season she had selected a cucumber the exact length of her forefinger, and going to a lonely spot where no one could see and break the spell of the magic sentence she recited, she swallowed it whole, not allowing even the end to come in contact with her teeth, but even this did not cure her.

There seemed no other way left for them but to call a physician. This was no simple task, for Miss Liu had never held converse with a man outside of the family, and it would be exceedingly immodest to talk over her symptoms with an entire stranger. The women of the house. hold were very much disturbed, when the father offered a suggestion that seemed a way out of the difficulty. Mr. Wang, the village schoolmaster who had recently come among them, had, in a friendly way, writ ten prescriptions for some of his friends with happy results, and the vil lage druggist had said that they were the most scientific compounds he had ever compounded, some of them calling for his rarest, most expensive drugs, and for others he was obliged to send to the city as he

did not have the ingredients in his shop. The boys in his school were full of stories about him. Two boys who had returned to the school room one night had seen him making his famous plaster and could testify that the eight poisons were put into it, for on his table were scorpions, lizards, snake skins, bats, turtle, rat and toad and black feathers all dried and ready to be put into the mortar to be ground up. These boiled with resin, beeswax and honey had, when applied to an abscess, caused it to discharge pus in less than twelve hours. Mr. Li, who was a chronic sufferer from lumbago, is now up and about his work. These and many other cures were cited to show that this modest man was of no mean talent. It was further stated that in diagnosing disease he was an expert. He could not only detect the six pulses at the wrist and locate the disease, but a lady in a village nearby had been successfully treated without seeing him. She had held a string and he had located the trouble by it. It needed but little discussion to convince the family that this great teacher and healer was ordained of heaven to minister to them in their necessity.

The servant was sent in haste to the distant market, for it must not be due to any lack of courtesy on their part that Teacher Wang would not do his best. Birds' nests for soup, sharks' fins for relish, ducks fattened by forced feeding, and the strongest wines were a few of the things purchased.

A card was written on red paper, and in the most minute characters, for by this they could show how happy they were to invite him, as expressed in the red paper, and their own modesty, by the size of the characters. At the appointed hour Mr. Liu went in person to remind him of his engagement and escort him to his house. He assures him that before he had condescended to come to their mean village, he had heard of him by reputation, and since coming, there were none who were not singing his praises. On reaching the house of Mr. Liu they were seated at a table and were served to roasted melon seeds and salted peanuts while waiting for the feast. A curious crowd had lined up under the windows, and wet fingers had insinuated holes in the paper that would accommodate as many eyes. Mr. Wang's reply is still remembered by many in the village. He said that he was living a simple life.

Often in his zeal to help others he would forget his own food, and like Confucius in his younger days, welcomed poverty because the simple life allowed him more time to devote to others. For the want of a pillow he could sleep dreamless sleep with his head resting on his bent arm. (Quotation from the Confucian classics.)

The feast progressed and wine was served before the cause of the meeting was discussed. The maiden's tender years, Mr. Wang's youth, and the custom of the country, were cited as reasons why the patient should not be seen. Mr. Wang was equal to the occasion. Taking from his sleeve a ball of string he asks that it be carried into the sick chamber and held by the patient. His face takes on the gravity of one who feels that he is dealing with momentous questions and alert to do his best for the fair sufferer. For one moment he hesitates before interpreting the subtle waves that come to him on the cord, but when he does speak it is to the complete satisfaction of the anxious friends crowding the doorway behind the curtain and the crowd elbowing outside the window. It more than repays them for their long wait. He says: I detect in the patient a condition seldom met with in one so young. The gases in her stomach are of sufficient pressure to suspend the food therein. These gases divide into hot and cold. The hot filling the air passages going to the head, causing headache, the cold passing down, causing pain in back and limbs. These gases must not be allowed to roam at will over the body. I shall strive to close up the air passages and force them into natural channels. The eczema that she has on the feet (all Chinese women with bound feet have eczema as they seldom if ever