This is a reproduction of a library book that was digitized

by Google as part of an ongoing effort to preserve the

information in books and make it universally accessible.

https://books.google.com
H610.2173
GENERAL LIBRARY,
Hish B25231 UNIV. OF MICH .
6E
MAR 24 1905

The HAHNEMANNIAN

INSTITUTE

Vol. XII FEBRUARY 28, 1905 No. 3

SERVICE IN STATE HOSPITALS.

C. SPENCER KINNEY, M. D.

Proprietor of Easton Sanitarium , Easton, Pa.

At the end of your college course when you find yourself

ready to take up regular medical work, the question of a choice
in practice confronts you. With the majority it will be pri-
vate practice, which calls for a well-prepared man who should
be as resourceful and gentle as he is brave. Even the experi-
ence gained in a hard country practice develops a man more
than is commonly believed . If he has common sense he will
need it, if he has not he will go down, as medical work in the
country particularly, needs clear hard sense, strength of char-
acter, and a resourcefulness in the application of one's knowl-
edge second to no other profession . The city practitioner can
secure assistance without delay when in doubt, and knowing
this does not always stimulate him toward self- reliance. The
attainment, however, of the qualities most desired depends
much upon the tastes, means, time and opportunities of the
ordinary graduate.
To those interested in the study of mental diseases, I
would call attention to the various State Hospitals for the in-
sane in which medical service offers unusual opportunities for
experience, with good compensation and promotion if earned.
New York State offers superior advantages in hospital meth-
ods, embracing clinical study and pathological research. To
those not afraid of work, who love study for the pleasure and
breadth it gives, who possess tact and good powers of obser-
vation and are ready to pass a Civil Service examination, the
following letters in reply to an inquiry of mine may be of in-
terest :
 66% THE HAHNEMANNIAN INSTITUTE.

Middletown State Homeopathic Hospital,

Middletown , N. Y., Jan. 27th, 1905.
Dear Doctor Kinney :
Your note concerning medical internes in the State Hos-
pital service is received. At the present time we are in need
of two medical internes and one clinical assistant. On March
Ist we will need one junior physician, as at that time Dr.
Turner will sever his connection with this institution .
I note, among other things, that you ask the variety of in-
ternes we need. 'We need male internes,-intelligent, active ,
young, single men. Men who are likely to become interested
in their work and remain in the service for a long period ; men
who will not fall into ruts, but who will be keenly alive to their
duties and will keep up with the advancement of psychiatry.
The other qualifications besides these, I think you understand
as well as I.
You of course must know that the opportunity for ad-
vancement and promotion in this line of work is greater to-
day than it has ever been before. The hospital at Patton, Cal.,
has been begging for physicians for some time. At Gowanda
and at Middletown the staff has been short either one or two
or more men much of the time. Connecticut and Pennsylvania
are both building homeopathic hospitals for the insane, and it
seems to me that the outlook for advancement at the present
time is very encouraging.
I am, sincerely yours,
M. C. ASHLEY,
Superintendent.
Gowanda State Homeopathic Hospital,
Gowanda, New York, January 30th, 1905 .
Dear Doctor Kinney :
I am in receipt of your letter. In reply I would say that
we will be in need of one more interne this year.
With best regards , believe me
Very truly yours,
D. H. ARTHUR,
Superintendent.
The two hospitals heard from here show the condition
prevailing throughout the country, an ever growing demand
for men of ability. In this department of the State service
you become familiar with the latest researches in scientific
psychiatry, and the equipment and opportunity for interesting
and progressive study, n but in general
 THE HAHNEMANNIAN INSTITUTE. 67

medicine, post mortem and surgical work is of the best ; you

become accustomed to advanced methods of clinical study,
making of each case a record of value, and the importance of
this training not only to the physician but also to the patients
who may come under his care, cannot be too highly appre-
ciated. There comes gradually from this carefully directed
system, an increase in the powers of observation, skill in the
use of instruments, tact in the handling of cases, and that
subtle value of habitual comparison , all of which are invaluable
and tend to deepen our respect for one of the most interest-
ing departments of medical research.
The meetings of the staff which are held at regular in-
tervals for the discussion of the work in hand, the interchange
of ideas culled from past experiences, and the contrast with
views of other workers outside your own circle, taken from
reports, journals, and books, tend to add greatly to your own
stock of knowledge .
You will have access to the latest books and periodicals,
well arranged laboratories and operating rooms, with depart-
inents of hydro-therapy and electro-therapy, all of which are
essential features in the State service of New York to-day.
Observation of the management of the hospital itself is a
very necessary part of one's education for this special work .
You should count, measure and weigh every method employed
throughout the house, and the study of a single department
is worthy of all the time you can devote to it, for the day may
come when you will be called upon to direct the course of
household events, for which duty each one of the staff should
endeavor to be fully prepared .
At present our school has hospitals for the insane in New
York, Massachusetts, Connecticut, Pennsylvania , Minnesota,
and California. Unless men with the required hospital ex-
perience can be found to fill the positions constantly opening ,
the advantages secured through legislation , many of which
have been the result of long, hard fights, may be of little use
to us. We have established a demand for young men of prom-
ise, with alert minds well trained in medical truths and practi-
cal methods , who are ambitious not only for themselves but
for the school in which we believe. It is no longer possible
to fill one of these hospital appointments properly with the
"available man." The call is for a thoroughly up-to-date ex-
perience through sharply defined hospital methods and rou-
tine, in a man whose education and special fitness is unques-
68 THE HAHNEMANNIAN INSTITUTE.

tionable. To take a contrary stand simply signifies inexperi-

ence.
The importance of the foregoing statements cannot be
over-estimated, and I trust that the present scarcity of eligible
applicants for State positions may cease to be a matter of
comment.
Appended is an extract from the Examinations for Medi-
cal Positions in the New York State Civil Service Examina-
tions :
THE STATE HOSPITAL SERVICE.
The State hospital service comprises fourteen State hos-
pitals under the supervision and control of the Commission in
Lunacy, the pathological institute, and two hospitals for the
criminal insane under the superintendent of Prisons. Over
30,000 patients are treated annually, and the service presents
the best available opportunity for the practical study of in-
sanity. The institutions are organized on hospital lines, with
training schools for nurses and good hospital equipment, in-
cluding laboratories, examination and treatment rooms, and
surgical operating rooms. The Pathological Institute in New
York City, under the direction of Dr. Adolph Meyer, is part
of the service and has intimate relations with the hospitals.
There are about 160 salaried medical positions in the State
hospital service. Comfortable furnished quarters, board and
laundry are provided for all appointees, and for the families
of superintendents and first assistant physicians, in addition
to the stated salaries. To those who take up the work as a
career and apply themelves earnestly, promotion is certain and
as rapid as is consistent with the period required for good
training and maturity of judgment. Within the last eight
years 67 persons entering the service as medical internes have
been promoted to junior physicians, and two to women phy-
sicians, 34 junior physicians to assistant physicians, six assist-
ant physician to second assistant physician, 16 assistant phy-
sician to first assistant physicians, one first assistant physician
to medical inspector, and seven first assistant physicians to
superintendents, while II physicians in the State hospital ser-
vice have been transferred to more lucrative positions in other
State Institutions.
The positions are graded at each hospital as follows :
I. Clinical assistant. Receives maintenance without sal-
ary. Open to all satisfactory graduates in medicine without
examination. Application for the position should be made di-
rectly to the hospital superintendents. This position affords an
 THE HAHNEMANNIAN INSTITUTE . 69

opportunity for recent graduates and general hospital internes

to get an insight into psychiatry before entering private prac-
tice. The period of service as clinical assistant is counted to-
ward the hospital experience required to enter the examination
for sixth grade physician, and those intending to enter the next
examination for a salaried medical position can scarcely spend
the interval more profitably than in this position .
2. Medical interne. Salary $600. Open to men and
women. Appointees will be expected to obtain licenses to
practice in the State within one year and to enter the first
examination for sixth grade physician after completing the re-
quired hospital experience.
3. Junior physician . Salary, $900 increasing to $ 1,200.
Open to men and women.
4. Woman physician . Salary, $ 1000 increasing to $ 1,500.
5. Assistant physician. Salary, $ 1,200 increasing to
$ 1,500.
6. Second assistant physician. Salary, $ 1,500 increasing
to $2,000.
Filled by promotion from the grade of junior physician
without examination .
7. First assistant physician. Salary, $2,000 increasing to
$2,500. Filled by promotion upon competitive examination open
to assistant physicians and second assistant physicians who
have had at least three years experience in a hospital for the
insane.
8. Superintendent. Salary, $3,500 increasing to $4,500.
Filled by promotion upon competitive examination open to
first assistant physicians.
In all grades above medical internes, salaries increase
$100 a year until the maximum is reached .
In the Pathological Institute there are the following po-
sitions for which special open competitive examinations are
held when required : Director, $5000 ; associate in physiologi-
cal chemistry, $ 1,800 ; associate in neuropathology, $2,000 ; as-
sociate in clinical psychiatry, $1,400 ; autopsy physician,
$1,200 ; assistant in physiological chemistry, $800.
70 THE HAHNEMANNIAN INSTITUTE.

THE PROCESS OF CURE.

On Jan. 21 , 1905, I was called to a patient residing in a

small town about forty miles from our city, who had been
suffering from a low fever, some three weeks, the last of
which he had been in bed on a milk diet. For two hours or
so in the forenoon his temperature would remain normal.
While the afternoon temperature would range from 100 de-
grees to 101 2-5 degrees, and one rceord said , 102 1-5 de-
grees F.
The patient called one homeopathic ( ? ) practitioner af-
ter another, took the various prescriptions , ending with a 10
gr. capsule of quinine, after which he rebelled.
He was a man 5 feet 9 inches tall, 192 pounds weight in
health, 43 years of age , well proportioned, robust, sanguinary
habit and of gouty tendencies. His first two weeks were
spent shivering over the register in a hot house with a tempera-
ture at about 100 degrees F. , headache, soreness of eyeballs
and backache. During that period he also had some slight
twinges in the toes. He was hungry, bowels regular and had
caten regularly until such time as he was put to bed on a milk
diet.
At the time of my visit his fever was confined to after-
noons. At about 2 P. M. he would call for a hot water bag to
his feet, his headache, from temple to temple, dull ,-the
backache,-sacrum, across and down thighs, the soreness of
eye-balls , all would increase with the temperature, until
sleep, to which he was late in going, because he "was so warm ."
He sweat about the neck and upper trunk in sleep, the odor
was offensive, as was his breath. The tongue had a slightly
yellow, thin coating posterior two-thirds. The stools were
regular, formed , consistent, but of the color expected on a milk
diet ; urine, dark but clear. The symptoms were not absent
between the aggravations, but were increased. The chills be-
ginning in the back, which had troubled him when about the
house , had disappeared in bed, and the cold feet seemed to
have taken their place. Thirstless. I sat myself down to think
it out.
"Paroxysms return at 2 P. M." Ars., Calc. , Canth. , Cic. ,
Cur., Eup-perf. , Gels. , Plat. , Sil. , Sul.
"Heat, without thirst." "Sacral pain." Eup-perf. , Iod . ,
Kali . c. , Sep.
"Soreness , eye-balls." Eup -perf.
 THE HAHNEMANNIAN INSTITUTE. 71

"Darting pains, temples, side to side," E. perf.

"Prostration, extreme, unreal, " E. perf.
Canine hunger with fever," E. perf.
"Most characteristic condition being a bilious derange-
ment partaking of a malarial character," E. perf.
"Rheumatism and gouty affections," E. perf.
At the bedside I had not thought of Eup-perf, but read-
ing between the lines it seemed to me to fit present conditions
and he received one dose. Eup-perf. 200.
Jan. 22. Report over telephone in the evening. Temper-
ature good, appetite good , no headache or backache, patient
sitting up in bed smoking a cigar ; most cheerful.
Jan. 24. Out of bed. "Shaky on feet." Temperature 4
P. M., 99 4-5 degrees F. , other symptoms slight.
Jan. 26. Temperature 4 P. M., 100 degrees F. Head
and eyes ache. Eup-perf. c. m.
Jan. 27. Better. No symptoms ; slight rise in tempera-
ture 5.30 P. M. Stool white .
Jan. 28. Eup-perf. c. m . F.
The 28th and 29th he developed a new symptom : "A
pressing down, sore sensation in hypogastric region, causing a
desire to urinate and pass gas," but did neither.
The increased need of frequent repetition and the new de-
velopment, if it persisted, signified a new prescription, which
would probably mean change to a deeper remedy.
The rule for making a second prescription by "first tak-
ing the new symptom and comparing the remedies found un-
der it with the remedies found under the early symptoms not
yet eradicated," led to the following study : The " soreness
hypogastrium," "ineffectual urging to urinate," was covered
by : Acon., Arg-n ., Ars. , Aur. , Calc. , Canth. , Caust., Cycl. ,
Eup-perf., Hyos . , Laeh., Men. , Op. , Phos . , Prun. , Puls., Rhus . ,
Sabina., Sars., Sep. , Sul. , Verat.
The "perspiration, upper body," by : Eup - perf., Op . ,
Sep. , Verat.
The "thirstlessness during heat" by : Eup-perf. , Op. ,
Sep.
It began to look like Op. , but the evidence was still in-
sufficient.
Feb. 1. The report that, although the temperature was
but 99 2-5 degrees, and he had had a good night, he had ached
across hips and down thighs to knees towards morning. Was
"all in," had no interest in work ; light stool, etc. By the way,
72 THE HAHNEMANNIAN INSTITUTE.

he had taken up and continued to do his usual work from the

28th .
The "aching sacrum extending to knees" was covered by :
Cimicif., Lil-tig., Sep.
The "light stool" by : Sep.
Gouty : Eup-perf., Sep.
I at once sent Sep. 50 m. ( Ge. ) .
The reports of continual improvement, daily, the last
symptom to appear the first to go, the sacral pain vanishing,
by degrees, with the temperature seemed conclusive evidence
of the correctness of the prescription.
Query: What should have been the diagnosis ? Why did
not the first prescribers cure , and how do I know that the
medicines given by myself cured ?
The thorough examination of abdominal parietes, without
eliciting signs of soreness gurgling, etc. , the absence of the
usual variations in temperature, the absence of diarrhoea, pre-
ciuded, to me, the suggestion of even ambulatory typhoid. The
periodicity suggested malaria. But the previous history of
the patient, his fondness for good living, suggested gout which
was confirmed by the occasional shooting pains in toes and
finger joints.
It is usually noticeable in the symptoms of a clearly in-
dicated remedy, as in this case, that it points clearly to a diag-
nosis of the basic disturbance.
It seemed to me that the earlier prescriptions failed to
meet the condition, primarily of course, because homeopathi-
cally not indicated, but really because they were aimed at the
wrong point, probably the temperature, which is apt to create
havoc in many minds, or the name of a disease, which is worse .
With our present knowledge of drugs and their application to
disease the practice of grouping them as typical of certain dis-
cases, as typhoid, scarlet or continued fever, etc. , and prescrib-
ing them because we have concluded that such is the condition
presented, is like following a "Will-o-the-wisp," because the
variations of these diseases are so great and so many as often
to be unrecognizable.
How do I know that my prescription cured and the patient
did not "get well himself?" Because a homoeopathic physician
has had the results of scientific observation recorded for him
in an unmistakable manner Hahnemann says in Section 253
of the Organon, that the first indication of improvement, after
the administration of the well selected remedy, is "a greater
degree of comfort, increased calmness and freedom of mind,
 THE HAHNEMANNIAN INSTITUTE. 73

higher spirits , a kind of return of the natural state. " He did

not say "removal of symptoms."
Now on the day of the administration of Eup-perf. the
patient had described himself as feeling " rotten," "no ambi-
tion, " would as soon " lie there as not, " aside from his physical
distress. The day following, the report over the telephone was
jubilant, the patient feeling better, and puffing a cigar, while
the family were unable to express sufficient gratitude.
Hering, in the preface to Chronic Diseases, Edition 1845 ,
had noted that the progress of cure was "from above down-
ward and from within outward." While many other observ-
ers have confirmed the observation and it has passed into an
aphorism : that " disease is cured from above downward, from
within outward, or in reverse order of its coming." A mo-
ment's thought convinces us that this is true, as in that way
only does sickness withdraw from the life- centers, head, heart
and nervous system, to the peripheral, or distal points of the
organism .
The head symptoms were first to go, the tongue cleared
next, the sacral aching followed. While the temperature, prob-
ably the first to be noticed, was the last to withdraw.
Was it necessary to first study the case from the view-
point of gout ? I do not think so. Primarily, the number of
medicines found to be effective in gout, or any other dis-
ease, is still indeterminate. But, when the symptoms of
disturbance, taken together, indicate a medicine that has often
been found useful in the treatment of the disease confronting
us, we may congratulate ourselves that our observation of the
case and the recorded knowledge of the remedy, coincide and
diagnose the condition. That Eup-perf. and Sep. were both
effective in gouty conditions was good to know.
In the second prescription following an acute attack, or
exacerbation , of a chronic nature, we all find difficulty. The
observations and success of our very best teachers show that
a second prescription, following the well indicated and excel-
lent action of the first, must be made with care, and after the
vital force, through the organism , has called for it through de-
terminate and persistent symptoms : i. e. , not evanescent
symptoms.
It is difficult always to see this call, and it is often more
difficult still to wait for the organism to make it, but, I be-
lieve it will come, definitely, in all curable cases .
This case has been cited simply because it was sufficiently
74 THE HAHNEMANNIAN INSTITUTE.

clear to illustrate the method of procedure under best possible

circumstances .
Eup-perf. , a comparatively short-acting remedy, is not of
sufficient depth to eradicate tendencies of the deeper and more
profound sort, but the signs by which the needed remedy
could be selected were forthcoming, and the progression was
correct from the time of its administration.

S. L. GUILD-LEGGETT, M. D. , H. M.

Syracuse, N. Y.

CREDIT FOR YEARS OF PRACTICE.

The demand for lenient examinations for practicians who

have been out of college and actively engaged in practice for
a number of years , or in other words, the demand upon ex-
amining boards for credit for years of experience in practice,
is now met in a partial way by the Illinois Medical Examining
Board . Beginning January 1 , 1905, that board will give 5 per
cent. upon the required average of 75 per cent. for each period
of five years of reputable practice. That is, an applicant hav-
ing been engaged in the practice for five years need make an
average of only 70 per cent. to pass, instead of 75 per cent.;
ten years, 65 per cent., etc.-Medical World.
 THE HAHNEMANNIAN INSTITUTE. 75

The Hahnemannian Institute

Published during the college year for an association of the students, the " Institute" .
of Hahnemann Medical College, of Philadelphia, Pa.

EDITED BY COMMITTEE ON PUBLICATION

CLASS EDITORS
S. M. S. JENNINGS, '05 '07
J. H. SWICK , '06 K. R. BARNUM, '08
BUSINESS COMMITTEE
H. K. ROESSLER J. W. FRANK W. O. HUTCHINSON

EDITORIALS .

We desire to call to the attention of the students the fact

that the time for the annual institute dance is drawing near.
This event is strictly a college affair and should call forth the
interest of every student. When the committee comes to you
for your subscription do not put them off but cheerfully give
them your name and money. There will be good music for
those who dance, cards for those who do not and a good feed
for everybody, so that there can be no excuse for anyone to
stay away.
The students must support this dance if it is to come off
and not wait till the last moment before doing so.

We are very glad at this time to say a word about Dr.

Northrop's illustrated lectures on Anatomy. These lectures
seem to have become a part of the required instruction in the
Anatomy Course in our college. No roll is called before the
beginning of the lecture, no questions are propounded to the
students ; we are simply invited to come and to drink deeply
at the "refreshing" fountain.
At this time of the year almost every man in the college
begins to take a thought for his Anatomy-the Freshman and
Sophomore for his finals, and the Junior and Senior for his
examination in this branch before the various State Examin-
ing Boards . To all therefore Dr. Northrop comes as a friend
in deed.
76 THE HAHNEMANNIAN INSTITUTE.

The members of the Senior Class, through the influence

of Dr. Mohr, will during the rest of the year have an opportun-
ity for gaining some practical experience in the emergency
ward of the Hospital. Arrangements have been made to have
two men on duty each night from 8 to 12 P. M.
Owing to the large number of emergency cases that are
constantly coming in, every man will have a good opportunity
for seeing and assisting in treating a number of cases. This
is a mode of instruction that has heretofore been neglected, yet
it is just what every one may most need when he begins to
practice. When a young physician is confronted with a per-
son in an unconscious state he must have recourse to objective
signs and manifestations to diagnose the trouble. The theory
of such condition is well taught in the lecture room but the
practical instruction comes only by being brought face to face
with the condition.
The only restriction that the Doctor has put upon the
boys is, that they do not make the office a smoking den. It is
to be hoped that the members of the class will conduct them-
selves in a manner becoming Seniors so that similar privileges
may be granted to coming classes.

NOTICE OF THE EXAMINATION FOR INTERNES

IN THE METROPOLITAN HOSPITAL OF
NEW YORK CITY.

The Metropolitan Hospital of the City of New York has

twenty-two resident physicians. Its competitive examination,
open to all graduates in medicine, for the fifteen services of
eighteen months each, commencing in June and December,
1905, will be held on April 28th, 1905.
Applications should be addressed to Edward P. Swift,
Chairman Committee of Examination , No. 170 West 88th St.,
New York City.
This Hospital has over 1,000 beds, and gives unusual op-
portunity for experience in Surgery, Gynecology, Genito-
Urinary Diseases, Neurology, Dermatology, Physical Diag-
nosis and general medicine, and Homoeopathic Therapeutics.
 THE HAHNEMANNIAN INSTITUTE. 77

COLLEGE COMMENTS.

Dr. Dudley in Recitation : "What is the most desirable

heat for a room ?"
Reeves, '05 : "Hot air."

Schultz , '05, is one of the men who applied for hospital ap-
pointment at Hahnemann. In view of the fact that quite a
number of the Seniors are applying, Dr. Schultz is developing
marked gelsemium symptoms.

Hamilton, Seip and Bullock have been appointed as in-

ternes to the Pittsburg Homœopathic Hospital,

Bradley, '05, recently had the misfortune to fracture his

ankle by a fall on the icy pavement.

Dr. Gramm : "What is the lesion of Comedo ?"

Killian, '06 : "Comedo Follicularum."
Dr. Gramm : "Mr. Barthmaier, what is the lesion of
Comedo ?"
Barthmaier, '06 : "A blackhead."
Dr. Gramm : "What is a lesion ?"
Barthmaier : "A solution of continuity."

Our friend Klock from Mahanoy City, who rather talks

"Dutch" than English, is a first rate fellow but, like all good
fellows, he has one weakness- he can't eat liver. His decided
aversion for it dates back to about a year ago when he ex-
amined a placenta. This idea of "can't eat any liver" was a
short time ago newly impressed upon him over in the "post"
room .

Dr. Snader (in sub-clinic ) : "What is your patient's

pulse, Doctor ?"
Wilson, '05 (after very wisely and carefully examining
the pulse ) : "Between 110 and 111 , Doctor."

'07 (a note sent to the desk during Dr. Northrop's lec-

ture) : A certain member of our class visited the Dime Mu-
seum and explained to an inquisitive bystander that the fetus
passed through the Obturator Foramen to reach the outer
world.
78 THE HAHNEMANNIAN INSTITUTE .

ALUMNI NOTES.

Dr. Clyde W. Sample, '03 , has opened an office at 742

Penn avenue, Wilkinsburg, Pa.

Dr. Arthur Leslie, '04, has located at 206 Minerva street,

Darby, Conn. Dr. Leslie was formerly resident physician at
Grace Hospital, New Haven, Conn.

Dr. Harold E. Dunne, ' or , has located at 325 Main street,

Ridgway, Pa.

Dr. Benj . E. Merrill, ' or , was married to Miss Caroline

Elizabeth, daughter of Mr. and Mrs. Sheldon Franklin Payne,
of Naugatuck, Conn . , on October 5th, 1904. He has located
at Dent's Run, Pa.

Dr. William Satterer, '03 , who finished his term as resi-

dent physician at Hahnemann Hospital in January, 1905, is
now practicing at South Orange avenue, corner of Arlington
aveue, Vailsburgh, Newark, N. J.

Dr. Frederick C. Hutton, '02, has announced the removal

of his offices to 728 East Allegheny avenue, Philadelphia.

Dr. H. C. Nicholson , '04, has opened offices at 2000 Wal-

lace street, Philadelphia.

Dr. C. Edwin Verdier, '04, has located at 35 South 19th

street, Philadelphia.

Dr. J. Willis Hassler, who is now at 267 Central Park

West, N. Y. , visited the college on Wednesday, Feb. 15 , 1905 .
From the ovation the boys gave him, they were all very glad
to see him in his old place again.

Dr. W. F. Ely, '03 , now of Lansford , Pa. , was seen about

the college halls last week. From his appearance, his drives
of thirty and forty miles daily, while attending to his prac-
tice, agree with him exceedingly.

Dr. Walter Fine, '04, has located at 536 Butler avenue,

Ambler, Pa.
 THE HAHNEMANNIAN INSTITUTE. 79

PART OF AN ADDRESS TO THE HAHNEMAN-

NIAN INSTITUTE.

BY JOSEPH C. GUERNSEY, A. M. , M. D.
Fellow Members of the Hanemannian Institute, that is to say,
Brethren!
In my day I have belonged to many organizations , social,
educational and medical ; but in no one of them was I a more
active member than in this Institute. I remember going to its
commencements, when a little boy, in the dingy old college on
Filbert street above 11th. The commencements were then held
in what was known as the "Lower Lecture Room ," which was
about one-quarter the size of this spacious apartment. The
classes of students were of course very small in those days,
but they made up in enthusiasm and hospitality what they
lacked in size ; and not uncommonly, after the Valedictorian
had spoken and the diplomas had been conferred, the students
passed around ice cream and cake to the pretty girls who were
present. If you have never done so, I do not see why it might
not be a good scheme some time for you fellows to hold your
commencement in this room and then adjourn to Alumni Hall ,
with your girls of course, for refreshments. I remember with
what awe and admiration I used to look upon the Valedictor-
ian and what determined resolutions swelled in my little breast
that when I grew up and became a medical student, I too
would be the Valedictorian. Many years passed away but I
never lost sight of my ambition , and when I graduated from
dear old Hahnemann, sure enough, I was the Valedictorian of
my class.
By this time the Hahnemann Institute had grown to much
larger proportions and was a great feature in our college lives
—perhaps greater even than it is now to you . We held our
regular quizzes every morning at nine o'clock- and
our Institute Commencements were looked forward to
with delight and were conducted with great pomp .
The class that graduated before mine ( the class your Dean, C.
M. Thomas, was in ) celebrated its commencement in the large
hall of the "Assembly Building," corner 10th and Chestnut
streets ; we held ours in Musical Fund Hall, Locust above 8th.
In those good old days the programs for these commence-
ments were always printed, with the names of Quiz-masters,
as Professors, and of course we had a band of music. Indeed
such an active interest was taken by the students in the com-
mencement of the Hahnemannian Institute, and so success-
 80 THE HAHNEMANNIAN INSTITUTE.

ful were we in drawing crowds of our lady friends and oth-

ers, that the Faculty of the college became very jealous of us
and declared we detracted too much from the glory of the regu-
lar college commencement. Our " innings" were always cele-
brated the evening preceding the regular college commence-
ment-the Faculty having theirs at noon next day. I held
the position of Quiz-master on Materia Medica in the Insti-
tute and I also had the honor of representing my class as Vale-
dictorian at our commencement. Now, of this particular com-
mencement, the Philadelphia Inquirer made a fine mess of
things next day by announcing that "the commencement of the
Homœopathic Medical College was held last night at the
Musical Fund Hall, the Valedictory address being delivered by
Joseph C. Guernsey, M. D., Professor of Materia Medica."
This was the nearest I ever got to holding that position and
it proved the last drop in the already too full cup of the Facul-
ty's discontent. The fiat then went forth that in the future the
programs must be printed with the names of the Quiz-masters
as "Quæsitores "-but they must not use the term "Professor."
In those days Homœopathy, Hahnemann's Organon and
Materia Medica were ably taught, in their strictest purity, by
such masters as Constantine Hering, the father of Homœo-
pathy in this country, Lippe, Raue, Henry N. Guernsey. Ver-
ily these were giants in Homœopathy. We were well in-
structed in the branches handled by those men, also in Anat-
omy by the late A. R. Thomas , M. D. , father of our present
Dean ; but in some others the teaching was lamentably weak,
Notably was this the case in surgery. We were taught sur-
gery theoretically from books and the operations were shown
us on the cadaver ; but to witness practical work on living
subjects we had to go to Blockley or the Pennsylvania Hos-
pital or the Jefferson. Once in a while word would be passed
"we are going to have an operation to-day at our college."
Every student would then be found in his place and breath-
lessly would we sit waiting for the operation which usually
proved to be the slitting up of a lachrymal duct or the open-
ing of an abscess or the removal of an ingrowing toe nail.
Only two real operations do I remember witnessing in our col-
lege during my student days-one was the amputation of a
leg and the other the amputation of a little finger. How dif-
ferent all this now is, you gentlemen well know. But it was
in that old college on Filbert street that I arrived at my high-
est eminence as a surgeon- for I was first assistant to Dr.
John C. Morgan, the Professor of Surgery. As I have just
 THE HAHNEMANNIAN INSTITUTE. 81

intimated, surgical material was so scarce that the poor over-

worked cadaver had to stand the brunt of all the operations
that were known in that day. I told you we had an amputa-
tion of the leg- Professor Morgan performed the operation,
I standing by to help tie the arteries, etc.; there were no
clips in those days, only slow tieing of each artery. We found
great difficulty in properly securing the bleeding vessels and
in spite of all we could do, the hemorrhage continued. Finally
Professor Morgan raised his eyes to the ceiling and called
for cobwebs- vehemently eulogizing their styptic power. The
walls and ceiling of that old operating room had once, in pre-
historic days, been white-washed and never cleaned nor even
dusted since. Ropes of cobwebs hung in festoons from the
ceiling, loaded with microbes of all sorts- and I promptly
stuffed them into the bleeding surface .
I do not perfectly remember the outcome of that case, but
I think the man died. I am sure he had sufficient cause to
do so.
I am announced to speak to you to-night on "Hahneman-
nian Hash." This title allows me to refer to various data con-
nected with our Hahnemannian Institute, with the Hahne-
mann Medical College of Philadelphia, with Hahnemann him-
self, with the system of medicine which he promulgated and
called Homœopathy and, finally, with the foundation upon
which Homœopathy was built and still stands-its MATERIA
MEDICA !
HOMOEOPATHY. -By this word we mean the curing of
disease according to the law of similars-like cures like. By
this we also mean that life work which each of us has chosen
as the best means of aiding and curing the sick. This curing
of disease we can accomplish ; this life work we can carry on,
only by the proper use of our Materia Medica . The founda-
tion upon which homoeopathy was established ; the rock upon
which it was built ; its dependence for its very existence both
now and for the future, is its Materia Medica. Hygiene and
dietetics, pathology and physiology, diagnosis and surgery, be-
sides other collateral branches, are as necessary to its exist-
ence as a system of medical practice, as are beams, bricks and
mortar to an edifice ; but of our edifice, the Materia Medica is
the corner stone.
Or, if instead of an edifice , we regard homoeopathy as the
"Arch of Cure" spanning all the diseases flesh is heir to, then
the Materia Medica is its keystone !
Just as a strong edifice can be built only by competent
82 THE HAHNEMANNIAN INSTITUTE.

mechanics-so Materia Medica can be taught only by compe-

tent teachers.
Hahnemann and his immediate successors gave homœo-
pathy the reputation and proud distinction which it enjoys to-
day, through the wonder and admiration they excited at the
cures wrought with the homoeopathic Materia Medica. Hom-
œopathy could never have been generated , born and brought
into existence without its materia medica-and, too , homoeo-
pathy has not made any progress since the day of its birth,
nor can it make any progress in all time to come, excepting by
and through its materia medica. We have a materia medica
of our own and a method of prescribing peculiarly our own.
I. We prescribe according to the law of similars.
2. We give the least possible dose (or quantity ) that
will cure .
3. We require that all repetition of the dose shall cease
while improvement continues.
If from the practice of medicine were eliminated our prov-
ings, our clinical observations and confirmations, our method
of administering drugs-for the homoeopathic materia medica
predicates and requires all these-homoeopathy would cease to
exist.

THE ACUTE DIARRHOEAS OF INFANCY-

SYMPTOMATOLOGY .

BY W. H. BIGLER, M. D. , PHILADELPHIA.

The term diarrhoea applies only to the symptom frequent

loose evacuations of the bowels, without any reference to their
ætiology. The summer months, especially July and August,
show an enormous increase in diarrhoeal complaints of all
forms. We speak of forms of diarrhoea , since there can be
recognized varieties of the complaint, both as to ætiology and
location of main lesions, and yet it is rare, if not exceptional,
to find any form presenting only the typical features usually
ascribed to it, unless it be of very short duration . There seems
to be a decided tendency under the enervating influence of
continued hot weather, aided by circumstances favoring the
development of other aetiological factors, to be mentioned later,
for a simple diarrhoea from acute indigestion, unless stopped
by treatment either by nature or the physician's art, to extend
by continuity along the gastro-intestinal tract, gathering
 THE HAHNEMANNIAN INSTITUTE. 83

strength and virulence as it descends, until we find it merging

into the other forms into which the summer diarrhoeas of chil-
dren have been divided .
Acute indigestion may result from faults in the quantity or
quality of the food taken, or from a lessening of the powers of
digestion, by influencing this through the nervous- system. Of
these latter influences the most imporant are chilling or over-
heating of the surface, fatigue , exhaustion, fright and denti-
tion. These factors, either alone or in combination with oth-
ers, are capable of so depressing the powers of digestion as to
cause even suitable food to remain undigested , and in this
state to act as a foreign body. It is seldom that we find acute
indigestion limited either to the stomach or to the intestines ;
usually both are disturbed, but not necessarily both in the same
degree. The retention of the food in the stomach for longer
than the normal period excites vomiting, preceded by nausea,
and more or less constitutional effects, varying according to
the age and susceptibility of the patient.
Owing to the absorption of the unconverted proteids in
the form of albuminoses a state of toxæmia may result, often
with alarming symptoms. There may be dullness, stupor,
even with contracted pupils, suggesting opium poisoning , or
restlessness , excitement and even convulsions. The prostration
with weak pulse is often marked. The temperature is usually
from 101 degrees to 103 degrees, but may rise even to 104 de-
grees or 105 degrees. Tongue is coated and appetite lost.
Epigastric distention may be present. In susceptible patients
the slightest error in diet may be sufficient to bring on a se-
vere attack. In older children these gastric symptoms may be
entirely wanting, while in the very young they may be en-
tirely recovered from without any serious disturbance of the
intestinal functions , owing probably to the ease with which
the stomach in the latter ejects its contents when not suitable
or liable to cause mischief. Hence, too, we find that when
the attack comes on gradually the gastric symptoms are trifling
or entirely wanting, and the symptoms of the intestines pre-
dominate . We then have colicky pain referred to the region
of the umbilicus, or shifting its location with the progress of
the undigested material through the intestines. It is indicated
by sharp piercing cries, restlessness and drawing up of the legs.
The presence or absence of tympanitis will depend upon the
character of the changes undergone by the undigested food.
Diarrhoea sets in , the number of stools varying from three or
four diem to as many as twelve or even more. The first stools
84 THE HAHN INSTIT .
E MANN UTE
IAN
are fecal, but soon change in character, becoming much thin-
ner than normal and frothy from the presence of gases. In
infancy they are at first yellow, then greenish and finally grass
green. Blood is not present, nor mucus, in the first few days.
Their reaction is acid. Undigested food is constantly present,
on a milk diet, as fat or masses of casein which are carefully
to be distinguished , the small yellowish-white masses of fat by
their solubility in equal parts of alcohol and ether, and the
masses of casein by their greater number, size and whiteness.
Iodine will serve to detect any unchanged starch which may
occur. In infants, the prostration with rapid pulse often be-
comes alarming.
Such attacks do not, as a general thing , except in the very
young or in delicate children, endanger life, but they do pre-
dispose to the occurrence of the more serious forms of intes-
tinal disturbance, to which the name of summer diarrhoeas is
commonly applied . Here it is generally agreed that there are
two sources of infection , one from without and one from with-
in, auto-infection, and that in both the altered conditions of the
intestines consequent upon disordered digestion are predispos-
ing factors in their production . In the first class of cases the
intestinal tract is rendered susceptible to the invasion of patho-
genic bacteria, and, in the latter, pathogenic properties are de-
veloped in the bacteria normally present .
Clinically we can distinguish simple gastro-enteric intoxi-
cation and true cholera infantum.
Gastro-Enteric Intoxication.- Mild cases with gradual on-
set are often neglected and passed over as due to dentition,
but the stools soon become more frequent, are thin, green, yel-
low or brown, containing undigested food. They soon be-
come offensive and mucus shows itself. The infants become
pale and flabby and lose steadily in weight.
Cases of sudden onset are characterized by restlessness,
distress and interrupted sleep. The temperature rises rapidly
to 102 degrees or 103 degrees, and even to 106 dgrees, with hot
dry skin, and usually great thirst. There may be depression
or excitement. Vomiting is an early, but not invariable, symp-
tom . First, the food which has been taken hours before is
ejected, then mucus, serum and sometimes bile. The char-
acteristic features of the diarrhoea which follows are the
amount of gas expelled, the colicky pains preceding the dis-
charges, and the foul odor. Soon the stools become entirely
fluid, and may occur as many as twenty times in twenty-four
hours, usually remaining offensive. After two or three days
 THE HAHNEMANNIAN INSTITUTE. 85

mucus appears. The free evacuations seem to be a conserva-

tive process on the part of nature, and are, in many cases, fol-
lowed by a drop in the temperature and general improvement
in the nervous symptoms ; and in three to five days, under fav-
orable circumstances, convalescence is established. When
such favorable issue does not occur, as in the very young or
in delicate infants, the symptoms do not abate, and in one to
three days death may ensue from exhaustion , or, where not
terminating fatally, it may run on with slight, but continu-
ous, rise of temperature, mucous stools, and wasting , into ileo-
colitis.
Relapses are liable to occur and may end fatally. In chil-
dren over 2 years of age the disease is less likely to result
fatally, but in them we frequently meet with eruptions, particu-
larly urticaria .
Holt mentions cases characterized by obstinate constipation
instead of diarrhoea, due to toxic paralysis of the intestines,
accompanied by high temperature, grave nervous symptoms ,
and sometimes marked abdominal distention.
In diagnosing between acute gastro-enteric intoxication
and acute indigestion, the higher temperature, more marked
nervous disturbances, and very offensive stools of the former
are most to be relied upon . If the temperature remains high
after the third day, we are led to believe that inflammatory
changes in the intestinal mucosa have taken place, which, with
the appearance of much mucus and even blood in the stools,
with continuous pain, will indicate the existence of an ileo-
colitis.
Cholera infantum belongs to the acute gastro-enteric in-
toxications, and the severity of its symptoms is due, not to an
extension of the lesions of the intestines downward, but to the
intensity of the infection . Cases of this extremely fatal dis-
ease occur for the most part in weakly, bottle- fed infants un-
der 2 years of age, chiefly in the months of July and August.
After a slight febrile movement, vomiting and diarrhoea
of a severe and exhausting character set in. The stools are
very frequent, containing very little fecal matter after the first
few have been passed . At first they are greenish, then re-
semble barley-water with a few flocculi of mucus, and scarcely
any odor. Vomiting is incessant, at first emptying the stom-
ach, then bringing up a greenish fluid. Within a few hours the
child has been brought to the last stage of exhaustion, and the
loss of weight is more rapid than in any other pathological
condition in childhood. The face is drawn, eyes sunken, fea-
86 THE HAHNEMANNIAN INSTITUTE.

tures sharpened, angles of the mouth drawn down, and a pe-

culiar pallor and expression of anxiety mark the whole coun-
tenance. The symptoms of nervous irritation marking the first
stage soon give place to dullness, stupor, relaxation and coma,
or convulsions . The rectal temperature is always elevated
(101-104 or 105 degrees in fatal cases ) , in spite of a clammy
skin and cold extremities. The pulse is rapid and thready, often
irregular, and finally almost imperceptible. Respiration irre-
gular and frequent, sometimes stertorous. The tongue is us-
ually coated at first, but soon becomes dry and red. Abdomen
is soft and sunken. Thirst is insatiable in spite of the vomit-
ing. Of course, very little urine is passed. The whole picture
is one of a choleriform disease. As the fatal issue approaches,
collapse from depletion sets in, and the symptoms first describ-
ed by Marshall Hall as spurious hydrocephalus, or hydrocepha-
loid, are manifested . With convulsions and a rise of tempera-
ture to 105 degrees or 107 degrees death is ushered in. The
prognosis is always grave, and the disease is an exceedingly
fatal one under any form of treatment.
Colitis- Ileo-Colitis- Enteritis Follicularis-Dysentery.-
In the gastro- enteric intoxications of which we treated above,
death or recovery takes place before any marked lesions of the
intestines have taken place ; in ileo-colitis, however, occur les-
ions varying in extent according to the duration of the pro-
cess, presenting the features of acute catarrhal inflammation,
involving only the mucosa ; catarrhal inflammation with super-
ficial ulceration ; ulceration with inflammation of the lymph
nodules ( follicular ulceration ) ; acute membraneous ileo- colitis.
The mild catarrhal form can at first scarcely be distin-
guished from an attack of acute indigestion , but soon the stools
begin to contain blood and mucus , often preceded by pain and
attended with tenesmus. The mucus may be clear and jelly-
like or mixed with fecal matter and streaked with blood. The
stools are almost without odor. Prolapsus ani is frequent.
There is loss of appetite, coated tongue, and prostration, with
slow convalescence after about a week of acute symptoms. The
first signs of improvement are the disappearance of blood
from the less frequent stools, and of the pain and tenesmus.
In the severer forms the absence of pain , and of membrane in
the stools, can alone distinguish them from the membraneous
variety.
Follicular ulceration seldom occurs under the age of 6
months, and can be suspected to exist when, after the sudden
onset of an acute gastro-enteric intoxication, we have a con-
 THE HAHNEMANNIAN INSTITUTE. 87

tinued temperature of 101 degrees with stools containing large

quantities of mucus without blood. The stools are seldom more
than four to eight in the twenty- four hours, dark green or
brown, and offensive . There is a steady loss in weight, and
the dry inelastic skin hangs in folds on the thighs. The ab-
domen may be either moderately distended or relaxed and soft.
Tenderness is usually not present. There is total loss of ap-
petite, and the tongue is sometimes dry and brown, with per-
haps, sordes on the teeth and lips. Thrush is often seen. Re-
covery is slow and seldom complete.
The membraneous is the most serious form of inflammation
in the intestines met with in children. Its symptoms are ob-
scure, and the only positive diagnostic points are the discovery
of patches of pseudo-membrane in the intensely injected rec-
tum, or the presence in the stools of shreds or flakes of mem-
brane. These appear as small , gray, opaque masses , easily
distinguished from transparent mucus, if the stools be washed
with water. Cerebral symptoms may mask the intestinal dis-
case. The prominent symptoms are, continuous temperature
of 102 degrees to 104 degrees, wasting, not rapid , but pro-
gressive, frequent stools, usually thin yellow or greenish in
color, often containing no mucus or blood , and occasionally
almost normal for a day or two. Duration is from one to three
weeks. It is very fatal in infants.
The points of difference between the various forms of
ileo-colitis are thus summarized by Holt : Follicular ulcera-
tion is distinguished by its lower temperature, rather subacute
course, infrequency of blood in the stools, and by the fact that
it is usually preceded by one or more attacks of acute gastro-
enteric intoxication, upon which its peculiar symptoms are en-
grafted. In the catarrhal form the symptoms of an acute in-
flammation of the colon are usually manifest from the onset-
bloody stools, pain, tenesmus and fever. In the membraneous
variety such symptoms are sometimes seen,but as a rule the local
sypmtoms are not pronounced, while the constitutional symp-
toms, especially those relating to the nervous-system , are us-
ually marked. The course is shorter and more intense than in
the follicular form . Death often takes place in ten or twelve
days during the period of most acute symptoms.
In all the various forms of infantile diarrhoeas we find
symptoms resulting from the development of lesions in other
organs. Thus we may have symptoms of bronchitis, broncho-
pneumonia, acute nephritis, or of degenerative conditions of
88 THE HAHNEMANNIAN INSTITUTE.

the heart, liver or nervous-system. Some of these lesions are

accidental, while others are doubtless the result of the circula-
tion in the blood of toxins derived from the intestines.
Hahnemannian Monthly.

VIRGINIA QUESTIONS FOR EXAMINATIONS,

JUNE 21-24, 1904

SECTION ON CHEMISTRY.

I. (a ) What is matter ? ( b ) What are the fundamental

properties of matter ? (c) How many and what dif-
ferent conditions of matter exist?
2. (a ) Do gases have weight ? If so, prove it. ( b ) Describe
the construction of a barometer. (c) Is the height of
the mercury column of a barometer higher at sea
level or on mountain ?
3. ( a) Explain the term quantivalence. ( b ) Mention some
univalent, bivalent and trivalent elements. (c) Sup-
pose a certain volume of hydrogen to weigh 20 grs. ,
how much will an equal volume of oxygen weigh,
provided pressure and temperature are the same?
4. (a) What is the difference between analytical and synthe-
tical methods ? (b) Define an acid . ( c ) Distinguish
between mono- , di- and tri-basic acids.
5. (a ) Explain the term allotropic modification. (b ) Men-
tion some elements capable of existing in allotropic
modifications. (c) What use is made of the syllables
ous and ic, ite and ate in distinguishing compounds
from each other ?
6. (a ) What is an alloy ? ( b ) What an amalgam ? ( c ) How
may most metals be obtained from their oxids ?
7. (a ) State the general properties of alcohol. ( b) By what
process is methyl alcohol obtained and what are its
properties ? (c ) What is glycerin, and how is it
found in nature ?
(a ) Give the general physical and chemical properties of
∞

urin. (b) By what chemical means can hemoglobin

in the urine be recognized ? (c) What changes in the
color of urine does the introduction of the following
drugs into the system produce : rhubarb, santonin,
carbolic acid and large doses of salicylic acid ?
 THE HAHNEMANNIAN INSTITUTE. 89

Answer any six of the above.

Pledge.
SECTION ON ANATOMY.

Answer only six questions.

I. Describe the atlas.
2. (a ) What is the skin ? ( b ) Name and describe briefly its
layers. ( c ) What are its appendages, and where
found ?
3. Give origin, insertion and action of the following muscles :
(a) Teres major ; ( b) flexor sublimis digitorum ; (c)
pronator radii teres.
4. (a ) What muscles flex the thigh ? ( b ) What muscles ex-
tend the leg ?
5. Name subdivisions of artery of lower extremity, and men-
tion branches of each subdivision, beginning with the
external iliac.
6. (a ) What would be the collateral circulation if the com-
mon carotid were ligated ? (b ) If the superficial
femoral were ligated ?
7. Describe the musculo-spiral nerve.
8. Bound the anterior and posterior triangular spaces of the
neck, and subdivide each space into triangles.
SECTION ON PRACTISE.
I. Name the commonest valvular cardiac abnormalities. Give
their usual cause in the aged, and in youthful pa-
tients.
2. Give symptoms and treatment of pulmonary edema.
3. Symptoms, cause and treatment of biliary calculi.
4. Symptoms and management of acute dysentery ( includ-
ing dietary and hygiene. )
5. Give differential diagnosis between chronic rheumatism ,
arthritis deformans , and gout.
6. Cause, symptoms and treatment of scabies.
Answer all questions. Number answers to accord with
number of the question. Put your number and the word, prac-
tice, on outside of your paper after folding. Sign pledge.
SECTION ON SURGERY.

I. (a ) What is suppuration ? Give causes and symptoms.

(b) What is phlegmonous inflammation, its causes
and treatment ?
2. (a) Give the technics of aseptic surgery. ( b) Name the
 90

.
INSTITUTE
HAHNEMANNIAN
THE
90
means of sterilization . ( c ) Name four methods of
controling hemorrhage.
3. (a ) What are the three general anesthetics in common
use ? and give mode of administration of each. (b)
Describe methods of producing local anesthesia, and
the strength of solutions used . ( c ) What are der-
moids ?
4. (a ) Give signs , symptoms, methods of reduction and
treatment of a subcoracoid dislocation of humerus.
(Give full description of dressings. ) (b ) Give diag-
nosis of thyroid dislocation of femur.
5. (a ) Give proper treatment for congenital talipes when
first discovered. (b ) Differentiate arterial, venous
and capillary hemorrhage. (c) What is a nevus ?
6. ( a ) What are aneurysms , their causes and varieties ? ( b )
What is a compound , comminuted fracture, and how
treated ? ( c ) Describe minutely the proper dress-
ings for Colles' fracture.
Pledge.
SECTION ON OBSTETRICS.

I. Describe the differences between the adult male and female

pelvis ; give the diameters of the living female pelvis
at the brim.
2. Describe the sutures and fontanels of fetal cranial vault-
referring to their diagnostic value during labor.
3. Name presentations of the fetus at term, with positions
pertaining to each.
4. Give mechanism of placental expulsion, and management
in this stage of labor.
5. Describe vaginal and vulvar lacerations resulting from la-
bor, and give the reasons for immediate repair of the
same by the obstetrician , and the mode of suturing
in both varieties.

QUESTIONS IN GYNECOLOGY.
I. What preparatory and post-operative treatment should be
instituted to secure a favorable termination in a case
of laparotomy?
2. Give the diagnostic symptoms of pelvic inflammation in the
female, and under what conditions would surgical in-
terference be necessary in such cases ?
3 Describe the different displacements of the uterus and the
best method of correcting and during retroversion,
 THE HAHNEMANNIAN INSTITUTE. 91

4. Which route should be selected , the suprapubic or vaginal,

in cystotomy in the female ? and give the technique of
the operation .

SECTION ON PHYSIOLOGY.

I. ( a ) Name some of the kinds of cells found in man. (b)

What is epithelium ? ( c ) What are its varieties ?
2. (a) What are the functions of epithelial tissue ? (b)
What are the vital or physiological characteristics of
protoplasm ? Name four. (c ) What are the varie-
ties of cartilaginous tissue ?
3. (a ) What is insalivation ? (b ) What glands make saliva ?
(c ) Which is the most important ?
4. (a) Describe the gastric juice. (b ) What is its action on
food ? ( c ) What is the succus entericus, and what
are its functions ?
5. (a) Give the most important branches of the tenth cranial
nerve. (b ) What is the function of the thirteenth ?
(c) What is the function of the third ?
6. (a ) Locate the visual center. (b) Locate the respira-
tory center. ( c ) What is the function of the cere-
bellum ?

SECTION ON HISTOLOGY, PATHOLOGY AND BACTERIOLOGY.

I. Give histological structure of the intestinal villi.

2. Describe (give morphology, biology, and pathogenicity of)
the streptococcus pyogenes.
3. ( a ) What is edema ? Give causes of ( b ) the edema of
passive hyperemia ; ( c ) of the edema of cachexia ; and
(d) of malignant edema.
4. (a) What is acute endocarditis ? Give ( b) varieties ; ( c)
etiology ; and ( d ) bacteriology of acute endocarditis.
5. What are (a ) osteoblasts ; and ( b ) osteoclasts ? ( c ) What
is a sequestrum ? (d) Explain sequestrum forma-
tion.
6. Give (a ) varieties ; and (b ) histological structure of pure
fibromata. (c) What are fibro-myomata ?
7. (a ) Of what variety of cartilage are the intervertebral
disks composed ? (b) Describe the ameba coli, and
name the pathological conditions in which it is found.
(c) What are myelocytes ? Where and in what path-
ological conditions are they found?
Answer six questions. Sign pledge.
 92 THE HAHNEMANNIAN INSTITUTE.

SECTION ON HYGIENE.
I. Give the sources of water, the impurities rendering it un-
desirable or dangerous for drinking or domestic pur-
poses, and the methods of testing and purifying the
same ; mention diseases traceable to impure water.
2. State the precautions necessary in securing cow's milk,
and in its preservation as a diet for adult invalids and
children.
3. What is meant by personal , domestic and public hygiene ?
4. What atmospheric conditions and localities favor sun-
stroke ; and what precautions necessary to avoid it?

SECTION ON MEDICAL JURISPRUDENCE.

I. What is meant by medical jurisprudence in regard to in-
sanity, murder and infanticide ?
2. State fully the symptoms and post-mortem appearance in
cases of poisoning by each-opium, strychnin and ar-
senic.
3. What is meant by the term, Erichsen's disease or railway
spine ?
4. In a medico-legal sense, what constitutes a dying declara-
tion ; and what is necessary to make it evidence in a
court of justice, and how should it be taken ?
Answer any three in each branch. Erase those not an-
swered, and pin printed list of questions to answers
turned in.

SECTION ON THERAPEUTICS.
1. Differentiate between arsenicum and apis in a case of
dropsy. State the principal clinical uses of (a ) baryta
carbonica ; and (b) baptisia . State the indications for
the use of kali bichromicum in catarrh and in ulcera-
tions . Prescribe the diet and general treatment for a
case of hemorrhoids .
2. Diff entiate between calcarea carbonica and podophyllum
er
1 in infantil diarrhea . What symptoms would cause
you to prescribe pulsatilla in a case of measles ? Dif-
ferentiate between bryonia and nux vomica in diges-
tiv troubles . State the principal clinical uses of san-
guinaria and rhododendron .
3. Differentiate bryonia from rhus in rheumatic fever. Name
two remedies useful in spasmodic croup, and give the
indications for each. Describe the headache for
which sanguinaria is useful. Give the principal clini-
cal uses of chelidonium and hydrastis.
 THE HAHNEMANNIAN INSTITUTE. 93

4. Give general treatment and diet for a case of typhoid fever.

Mention three remedies commonly used in acute ton-
silitis, and give indications for two of them. Differen-
tiate chamomilla from colocynth in a case of infantil
colic. Give the symptoms for pulsatilla and gelsem-
ium in dysmenorrhea.
5. Give the indications for the use of phosphorus and anti-
monium tartaricum in pneumonia. Mention two
remedies commonly used in acute gastritis , and give
indications for each. When are cold and when hot
applications of use in inflammatory conditions ? Men-
tion the principal clinical uses of spigelia and lycopod-
ium .
Answer four questions.
SECTION ON MATERIA MEDICA.
I. (a) What is polycrest ? Mention three. (b ) Describe
the ovarian symptoms of apis, lachesis and bella-
donna.
2. (a) Give the source, mode of preparation and physiologi-
cal action of silica. (b) Give the time of aggravation
of arsenic, nux vomica, pulsatilla and lycopodium.
3. (a ) Give the physiological action of sulfur. (b) Mention
three characteristic symptoms of each of the follow-
ing remedies : Mercurius, ipecac. iodin and cinchona.
4. (a ) Give the laryngeal and tracheal symptoms of (1)
belladonna ; ( 2 ) causticum ; ( 3 ) phosphorus ; and (4 )
spongia. ( c ) Give the mental and nervous symp-
toms of ( 1 ) aconite and ( 2 ) gelsemium.
5. ( a ) Mention the organs or tissues affected by ( 1 ) lilium
tigrinum ; (2 ) veratrum viride ; (3 ) plumbum ; and
(4) thuja. (b) Give the urinary symptoms of ( 1 )
terebinthina ; (2 ) cannabis sativa ; (3 ) lycopodium ;
and (4) nux vomica.
Answer four questions.
-Medical World.

OBITUARY .

DR. R. E. DUDGEON.

The late Dr. R. E. Dudgeon, a genial physician and gentle-

man, if ever one existed , sent the following "obituary" of him-
self to the Homoeopathic Monthly Review :
94 THE HAHNEMANNIAN INSTITUTE.

"My dear Brown :-I have written so many obituary no-

tices of departed colleagues lately,that I think, as my hand is in,
I might write one of myself and send it to you, not for imme-
diate publication in the M. H. R., but which you may keep in a
pigeon-hole till it is needed. It is not usual for a fellow to
write his own obituary, still history is not without a conspicu-
ous instance of this feat being performed ; in the case of Moses,
to wit, who tells us how he died and was buried in the land
of Moab, over against Bethpeor ; that is to say, if Moses wrote
the Book of Deuteronomy, which it would be irreligious to
doubt. Fortified by this illustrious example I subjoin my obit-
uary notice for the delectation of posterity.
"R. E. D., being a delicate child, his parents, fearing he
might die of consumption, if not properly attended to medi-
cally, persuaded him to become a doctor, so that he might learn
how to preserve his precious life. And this proved his salvation,
for in studying medicine, as taught in the schools, he soon be-
came convinced of the uselessness, or rather hurtfulness , of
medicine as taught, and so he steadily abstained from taking
any of it, and was, thereby, enabled to live long and to escape
his hereditary tendency to consumption. The leading char-
acteristic of his life is that he was always on the minority side
in all important questions, and that deliberately and intention-
ally, for he thought that truth, which he loved, was at first al-
ways in a minority, and that as soon as it became a majority,
it ceased to be interesting. He has now gone over to the ma-
jority, but it was not of his own free will, but only because
he could not help it. On becoming a doctor he naturally joined
the minority, and attached himself to the homœopathic school.
He practiced this system for many years, but never made a
fortune. He wrote many books, which were not much read.
His favorite pastime was controversial writing, and for this
his position as one of the minority gave him many opportuni-
ties. Though much engaged in medical polemics he never
made an enemy, or, if he did, they all died before him, so that
at his death he was unable to exercise the Christian virtue of
forgiving his enemies, but he could practice the higher virtue
of loving them , as they contributed so greatly to his enjoyment
of life. He was cremated at Golder's Hill on the of
, so we may say literally and figuratively : Peace be with
his ashes !
"Yours ever,
"R. E. D."
(Homoeopathic Recorder. )
 THE HAHNEMANNIAN INSTITUTE. 95

GRAPHITES IN ADENOIDS, ENLARGED TONSILS,

BLEPHARITIS , MARGINAL AND POST-
AURAL ECZEMA .

BY E. D. BROOKS, M. D.
Ann Arbor, Mich .

May 16, 1901 , a German woman, in humble circumstances,

brought her eldest son, a lad of about four years , to have me
see his eyes, and a sorry looking pair of eyes they were. The
lids , especially at the margins , were red and swollen , the lashes
loaded with crusts, the outer commissura cracked and oozing
a glutinous, yellow serum, the conjunctiva inflamed and dis-
charging a muco-pus, the corners of the mouth and edges of
the nostrils sore, cracked and oozing, the mouth constantly
open for breathing purposes, and on the face the listless, half
idiotic expression so common in children unable to breathe
through the nose. The child was poorly nourished, stupid and
irritable, and repulsive to behold. The faucial tonsils were
much enlarged, and the post-nasal space filled with adenoids .
Sleep was much interfered with by his efforts to obtain air,
and starting night terrors and choking were distressing to see.
I advised operation to remove tonsils and adenoids , but
for some reason, which I have now forgotten , a delay of a few
days was agreed upon, and I gave him Graphites, 30th potency,
to take in the interim.
Upon his return a week later his condition was so much
improved that the mother begged for a further delay of the
operation, and I weakly yielded, thus robbing myself of the
credit of another operation for this condition, for when he re-
turned a week later the indications for operative measures
were missing. He was breathing through his nose and sleep-
ing as sweetly as any child , the nose and mouth were healed,
the lashes were free from crusts, and the lids from inflamma-
tion, and she would not have brought him again except for a
slight redness and stringy discharge, which Euphrasia soon
relieved. I have treated various other members of the family
since then and have kept track of this case, so I am sure that
with the exception of a slight attack of measles during the
epidemic of the winter of 1903-'04, he has not had any sick-
ness since that time. He is doing nicely in school, and is as
nice and healthy looking a boy as one could wish . No adju-
vants were used in this case nor any change in diet nor sur-
roundings, nor did I receive any compensation for my ser-
vices.-Homoeopathic Eye, Ear and Throat Journal,
 IAN
EM ANN UTE
THE H AHN TIT
96 INS .

( Second Paper. )
ECONOMY IN HOMEOPATHY.

W. A. BURR, M. D.

Homœopathy not only saves life, but it saves time in lessen-

ing the duration of disease.
It would naturally be expected that a system of medication
based on a law of cure would heal disease in a less period of
time than another system of medication where prescriptions
were made in a hap- hazard or even in a rational manner. Na-
ture works best and quickest when the conditions for good re-
sults are most favorable, and in the healing of disease with
medicines the conditions are most favorable, other things be-
ing equal, when the law of Similia is observed, as has been
indubitably proved by thousands of intelligent physicians.
Curative processes are comparatively quick when there are
the fewest obstacles to overcome, and in homœopathic medica-
tion the obstacle of factitious disease from over dosing does
not have to be overcome because it does not exist. The medi-
cines are addressed directly to the diseased parts and the doses
used are so small they can work no harm. The medicine acts
quickest that acts with precision and definiteness, and this the
similar remedy does. The healthy organs and tissues are not
injuriously affected by it because it spends its whole force on
only the parts that are diseased.
All this refers of course to curative and not to palliative med-
ication.
Some records have been made showing the comparative
time required to work out curative processes under different
systems of medication.
“Dr. Kurtz collected a large amount of information respect-
ing many allopathic and homoeopathic hospitals, from which
is appeared that the average duration of treatment of the
patients in the allopathic hospitals was between twenty-eight
and twenty-nine days, whereas in the homoeopathic hospitals
it was only between twenty and twenty-one days. Let us say
that while allopathy takes an average of twenty-eight days to
cure, homœopathy only takes twenty-one days."
"In the Hospital St. Margurite of Paris, during the years
1849-51 , one-half of the beds ( one hundred) were under the
 THE HAHNEMANNIAN INSTITUTE. 97

care of Dr. Lessier, the other half (ninety-nine ) were in

charge of allopathic physicians. In these three years Dr. Les-
sier treated homoeopathically 4,663 cases, while during the
same period the allopaths treated but 3,724 cases. That Dr.
Lessier should treat 939 or 25.2 per cent. more cases than his
rivals in the same length of time, with but a single additional
bed, proves he needed for the establishment of convalesence
less than three-quarters of the time required by his allopathic
colleagues. "
These quotations from the Homœopathic Pamphlet Series
show, in a general way, the average duration of cases of dis-
ease under the two dominant systems of medication .
In the Denver Homœopathic Hospital during the year 1902
the average duration of all the cases of disease treated was
20.3 days, tallying closely with the cases quoted above.
Generally speaking, then, homoeopathic treatment reduces
the duration of disease about 25 per cent. This means that a
homœopathic hospital of 300 beds could care for as many pa-
tients as an allopathic hospital of 400 beds.
Could the persons having the management of hospitals and
other institutions where the sick are to be treated, appreciate
this fact a great saving of time could be brought about by in-
troducing the new school of practice.
Could the use of homoeopathy become general by the people
the saving of time, now needlessly lost through sickness , would
be immense, in the aggregate, and the relief from anxiety, suf-
fering and pain that could be thus secured to humanity, not to
be considered here, would be immeasureably greater than any
saving reckoned in dollars and cents ?-Progress.
 N
IA
NN
EM
A UTE
E HN TIT
98 TH HA INS .

TONSILITIS.

Inflammation in any form attacking the tonsillar region .

gives rise to symptoms of most distressing character and at
the same time provides a most favorable soil for the entry into
the system of other infection . It is well to remember that at
first this disease is only a local disturbance affecting the capil-
lary system and glandular structures and if promptly and effi-
ciently treated will remain local. The constitutional symptoms
such as fever, headache, etc., only develop when there is con-
siderable infection taken up.
In treatment the first indication is to increase local capil-
lary circulation . A local remedy must fill two requirements,
i.e., a detergent antiseptic and a degree of permanency in ef-
fect. Many of the remedies which have been advocatd for the.
varied forms of Tonsilitis are antiseptic but they are not suf-
ficiently exosmotic in their action to increase the circulation,
or else their effect is too transient.
Glyco-thymoline frequently applied in a 50 per cent.
strength with a hand atomizer, produces a rapid depletion of
the congested area through its well defined exosmotic prop-
erty, re-establishing normal passage of fluids through the tis-
sues, promptly relieving the dry conditions of the membrane
and giving an immediate and lasting anodyne effect. As a
gargle a 25 per cent. solution hot may be effectively used, pro-
viding the process does not cause undue pain. The external
application of cloths dipped in hot water and glyco-thymoline
in 25 per cent. solution greatly increases the venous circula-
tion.

ALL HAND WORK ✩

Subscribe for the
ENGRAVED TABLETS
For Churches, Hospitals and Other Institutions Hahnemannian
Engraved Metal Signs
Designs and Estimates Submitted $I a Year in Advance
FRED, J. FURNER. · IIII ARCH ST.
 UNIVERSITY OF MICHIGAN

3 9015 07481 0857

SAVES TIME

AND PATIENTS

The greatest auxiliary to any form of

medication in anaemic and consumptive

cases is live, healthy blood .

BOVININE

is the arterial blood of the vigorous bul

lock, antiseptically prepared by cold

process , and sterilized . It makes new

and enriched blood quicker and better

than any other known agent. There

is a prompt increase of red cells and

haemoglobin in the blood , together with

rapidly improving strength and func-

tions , shortly after administration is be-

gun. A postal will bring you our scien-

tific treatise on topical and internal ad-

ministration , and reports of hundreds of

clinical cases .

THE BOVININE
75 West ew York .
LEEMING MILES & CO. , MONTRE ominion of Canada.
 SANITARIUM
EASTON SANITARIUM , EASTON , PA.
DR. C. SPENCER KINNEY, PROPRIETOR

attention
accorded
personal

location
patient

leaves
Each.
Circulars
Request

WATER

The
SPRING
EXCELLENT

the
Terms

of
PURE
and

AIR
.and
CUISINE
on

nothing
desired
be
to.
.

EASTON SANITARIUM AND ANNEX.

Many improvements have been made in the EASTON SANITARIUM during the past few years
so that now, with handsomely furnished rooms, modern conveniences and the general air of home
comfort which exists about the place, it is especially adapted for the reception of those requiring
rest and medical treatment, whether it be for nervousness, mild forms of insanity or for drug habits.
The fact that for over twenty years Dr. Kinney was connected with the Middletown State Homœo-
pathic Hospital, N. Y., is a guarantee that a man of experience is in charge, and consequently
everything will be done for the comfort and improvement of the patient's condition . Visit before
deciding.
LONG DISTANCE PHONE 1661 , EASTON. EASTON SANITARIUM , EASTON , PA.

Patronize our

Advertisers

and mention the

The Hahnemannian

Patronize our Advertisers and Mention "The Hahnemannian ."