ternal skin, from the arrest of secretion which accompanies congestion and inflammation.

Apis has oedema as its grand characteristic, and was the second remedy prescribed. Hughes (Pharmacodynamics) considers it an excellent remedy in incipient Bright's Disease, to which post-scarlatinal dropsy belongs; and many of the symptoms of the case pointed directly to Apis. Thus we find many symptoms of dyspnoea and suffocation: sudden coryza with dryness of the nose, dryness and heat in the throat, with painful deglutition; but the cough symptoms of Apis differ, as the shocks of cough come from a crawling irritation down in the windpipe, and after this small lump of mucous becomes loosened and is swallowed the cough ceases directly, whereas in our patient we find rattling couga with expectoration; nor did this patient complain of headache, whereas under Apis the headache increases at every shock of cough. Clinically its action in dropsies has been too often verified, and it is only astonishing that in the provings we find so very few symptoms leading to it. Allen, in his Encyclopædia, gives us only oedema of the eyelids (Symptoms 160, 161, and 746), actual swelling and puffing up of the whole body, without any noticeable change of color, except in the face. Its action on the kidneys might be found in Symptoms 695, pressure behind on the last ribs, on both sides of the spine, which somewhat hinders breathing; 508 (secondarily), urine high-colored, with frequent emission of small quantities. Here Apis is the very opposite of Belladonna, which has primarily spasmodic retention of urine and secondarily, emission of large quantities of pale, thin, watery urine, whereas Apis gives us (500) repeated urination of colorless urine, and, secondarily, scanty and high-colored urine. After all, Apis was not given long enough to show decided effects, and thus we come to the third remedy.

Arsenicum. The experiments of Leyden and Mack show that arsenious acid dissolves the red blood-corpuscles; nutrition is thus disturbed, and fatty degeneration of the organs follows. Saikawsky considers this degeneration as an expression of a parenchymatous inflammation, caused by the irritation of the poison. (Nothnagel, Materia Medica, p. 214.) If so, it is

clear that we can expect very little from Arsenic in post-scarlatinal dropsy, for here it has not come yet to this dissolution. We find dropsy mostly in cases which apparently run a mild course, although from the very start the kidneys are affected. If we would only lend our attention early enough to this emunctory, many a case of scarlatinal dropsy could be prevented. Is Arsenicum in such cases the remedy for uræmia and uræmic convulsions? We have seen that according to Biermer the urinary canals become clogged up in this dropsy, and thus anuria with retention of urea follows; but Buchner (Morbus Brightii, p. 115) considers Ars. the curative remedy only for the narcotic form of uræmia, and in our case we find neither convulsions nor coma.

Superficial comparison of the symptoms of the case with those of Arsen. will give us even more than a simile; but pathologically the status is different, clearly showing that the pathological state cannot be neglected in the selection of the suitable remedy. Allen gives us in his Encyclopædia (391) œdematous, painless swelling of the eyelids; but the swollen nose pours forth a profuse, watery discharge or secretes a fetid ichor (500); and only Symptom 324 gives us stoppage of the nose, as from catarrh. Our case showed swelling and redness of the tonsil, whereas Arsenicum gives us the so often, in scarlatina, malignant swelling of the parotid and submaxillary gland and ulcerated throat (789 and 794). From the decomposition of the blood we can expect greenish, turbid, dark-brown urine, forming no sediment, although Rummel found sediment in the urine (1577, 1579); and we also find great inclination to urinate, but does not pass any urine (1549), or even perfect suppression (1567); and when the secreted urine was examined Ruaglis found albumen, fat globules, renal epithelium, fibrincasts, and blood-corpuscles; but all the animals experimented with died comatose, a fact which fully agrees with Buchner's indication for Arsenic in Bright's Disease.

Helleborus, the fourth remedy given, also failed to give any relief, although we find among its star-symptoms anasarca after suppressed eruption. It is said to do good service in anasarca and ascites of children, less in the case of full-grown persons;

and when we consider the easy irritability of the nervous system in childhood, the favorable action of Hellebore as a stimulant to the cerebro-spinal and sympathetic nervous system finds thus its explanation. In fact, its great remedial power is shown in hydrocephalus, in dropsy after intermittent fever; but we cannot see any similarity of Helleborus to the case on hand, showing us again that we must not prescribe according to a mere name of a disease, but that we must study the diseased state in all its bearings in order to find the right remedy. In our case there was no obtusion of the sensitive nervous system, so characteristic of Helleborus, nor any symptoms of paralytic weakness.

Hepar Sulph. cured the case. We have to thank Kafka for this exceedingly valuable therapeutical hint. He says (Hom. Therapie, I, 853), "I have tried Calcarea on account of the pastous and hydræmic state of the patient, and was disappointed. The same ill success followed the highly-praised Hellebore, Digitalis, Scilla, Asparagus; even Sulphur did not do the thing. Convinced that only that remedy could help which can aid us in the casting off of the croupous exudation in the urinary canals, and simultaneously improve the hydræmic state of the body, our attention was led to Hepar, s. e., third trituration, three powders a day; and already on the third day more urine was passed, the oedema became softer, and the patient's appetite returned. It is well known that Calcarea as well as Sulphur are grand aids in the amelioration of sunken vital power, and that they quickly improve the power of digestion." Kafka adds (II, 373), "We frequently observe that during the time of efflorescence the secretion of urine becomes considerably diminished; that the urine is tinged with blood; that it contains albumen, fibrinous cylinders, and blood-globules, and still neither renal pains nor fever. With such a state we can certainly expect dropsical effusions, which can be prevented by immediately giving our Hepar. Arsenicum may follow Hepar in severe cases, as soon as the quantity of albumen is considerably diminished, for the anæmia reconvalescentium, or Cinchona where the patient becomes easily faint, feels weak and exhausted, and digestion is at a low ebb."

VALEDICTORY ADDRESS TO THE FIRST CLASS OF THE BOSTON UNIVERSITY SCHOOL OF MEDICINE.

DELIVERED BY PROF. S. H. WOODBURY.

Members of the Graduating Class:

In the discharge of the duty imposed upon me by the partiality of my colleagues, the members of the Faculty, I stand here now to bid you farewell as students of this medical school, and to heartily welcome you to the profession which you have chosen and whose duties and responsibilities you have proved yourselves well qualified to assume. In the discharge of the first of these duties, I can only say to you, individually and collectively, that you go forth from this institution bearing the hearty good-will, the most earnest sympathy, and the firmest confidence of every member of the Faculty. And I do not say this as an empty compliment, not because something of this kind I am expected to say upon this occasion, but because the studious habits, the respectful demeanor, the real ability, and the earnest culture which you have uniformly displayed, during the entire period of our association as teachers and pupils, has earned for you the highest respect and confidence and friendship of the Faculty; and, therefore, it is a pleasant task for me here this evening, in the presence of your friends and the friends of the College, to bear witness to your unexceptionable deportment, and to the extent and thoroughness of your medical acquirements. And though we would still gladly retain you under our roof as members of our medical family, that we might each day feel the inspiration of your hearty greetings and your earnest attention to the daily lectures, yet we part with you with an abiding confidence in your acquirements and in your ability to command success in whatever community you may dwell, in whatever field of labor you may select. You may feel assured that it only requires the persistent employment of the same qualities as physicians which you have displayed as students to win for yourselves an honorable position in the community as well as in the ranks of your chosen profession; and to the attainment of these distinctions by each. and every one of you, members of the First Class of the Bos

ton University Medical School, the Faculty look with the most undoubting confidence.

In the discharge of my second duty, I welcome you to the ranks of the medical profession, - to its labors and toils, its cares, its privations, and through these to its rewards, its joys, and its compensations. And although from my intimate ac. quaintance with each one of you I know that what I am about to say can have no personal application, still let me say here in a general way to you, and to all, if you seek to enter the medical profession simply as a matter of business, for its profits, its emoluments, or its honors alone, pause upon its threshold. You will be disappointed. Its fruits, which may have seemed so golden to the eye, will be full of ashes and bitterness to the taste; you will weary of the tedium of its daily routine, and the tardy recognition of your skill and acquirements will fill you with disappointment and disgust; you will fall by the wayside, and find, perhaps too late, that in the choice of your life-work you have made a mistake. But if you find yourselves drawn to the life of a physician by a love of scientific research added to a desire to benefit your fellow-men, to relieve pain, to aid in educating mankind up to a higher standard of physical as well as moral and mental health, then indeed in adopting the medical profession you have chosen wisely; and if you do but serve with patience, performing with diligence and thoroughness the work which surrounds you, your opportunity for usefulness will surely come and your anticipations in entering the profession be fully realized.

And here let me call your attention, for a few moments, to the new relations which you are about to assume to the members of the medical profession, as well as to the community at large, many of which duties are of the most delicate character and will require of you the exercise of constant care and circumspection in their performance.

Let me commend to you, as among your earliest duties, the careful study of the code of medical ethics by which these duties are defined and their observance especially insisted upon. The fundamental principles upon which these ethics are based are of the most exalted character. They are first,