are that troublesome acne is greatly reduced, the amount of bromide required lessened, and the mental condition of the patient improved, and particulary is this so if there is present much mental dullness. The use of the strychnine and belladonna should be ordered to meet the eye symptoms so often found present in these. If there is faulty power of accommodation with weakness of the internal recti, strychnine is indicated. In cases where the external recti are weak, or the internal recti and accommodation overly active, the indications are for the administration of belladonna, or its alkaloid, atropia. In petit mal I attach much value to a course of chloral.

Permit me here to call your attention to a point that I have frequently noticed in connection with attacks of epilepsy. For some time, often several days, prior to an attack, the epileptic feels unusually well and buoyant. But just before the attack and subsequent to this period of bien etre he feels dull, restless and irritable. He is often troubled with headache, has a scanty flow of urine, and is easily provoked into a quarrel. The pulse tension is high, whereas in the period of wellbeing it was soft. The patient is morose and seeks seclusion. In these cases, it is often possible to avert the threatened storm by the judicious use of acids. None answers the purpose better than the free exhibition of lemonade. Here we have a scientific explanation for the popular custom of drinking the juice of the lemon to avert, and relieve, headache, with arterial tension, and throbbing temples. According to Haig, Von Jaksch, Garrod, Duckworth and myself, the drinking of an acid lowers the alkalinity of the blood, and wards off an attack. To a minor degree spirits ammonia acts like an acid, and affords some relief.

I have already said so much upon the subject of dietary, and its relation to uric acid, that I cannot go into any details on the routine drug treatment of epilepsy. Beyond what I have just stated on the bromides,

I shall ask you, on occasion, to try the hypodermic administration of morphia. The value of a hypodermic injection of morphia in puerperal eclampsia is now settled beyond dispute. I am not aware that it has been advocated in cases of epilepsy, where one fit follows another. This status epilepticus is readily controlled by the hypodermic injection of morphia. Along with the morphia I would recommend an aperient of calomel and croton oil. In this case, as in that of puerperal convulsions, the injections have to be repeated sometimes, but no harm can come from so doing. Some seven years ago, in an article on the "Management of Peurperal Convulsions," I mentioned the facts that the morphia rapidly reduced the high arterial tension of these cases, and caused diuresis and diaphoresis. Later investigations have shown that this plan removes the uric acid from the blood, and thus reduces arterial tension.

In one case of the status epilepticus that I had under my observation for an entire night, an excellent opportunity was afforded me to watch the tense condition of the pulse, and the action of morphia upon it. After a dozen convulsions had taken place in close succession, I gave one-third grain of morphia hypodermically. Subsequently to this there was only one slight seizure. The pulse became slow, full and soft. There was a copious flow of urine, the skin became moist, and the patient went to sleep.

In conclusion, gentlemen, permit me to say that it is with unfeigned pleasure I have brought before you the few thoughts contained in this paper. You are the honored members of the association in my own old county. Should it ever be my good fortune, in the ardent pursuit of scientific research in medicine, to do any really useful, or original work, there is no place else where I would more cheerfully give it to the world than at the Huron Medical Association, the county of the home and the memories of my boyhood.

Remarks on the Presentation of Diplomas to the Graduating Class of Barnes Medical College.

By C. H. HUGHES, M. D., St. Louis,

President of Faculty, and Professor of Neurology, Psychiatry and Electrotherapy.

GE

ENTLEMEN OF THE GRADUATING CLASS:-The battle is over and the victory is won. We now proceed to call the roll of honor. Not all who entered the lists are on the roll. Some have failed to pass the ordeal and have fallen in the field of endeavor. To the unfortunates we say, your failure to pass the ordeal is not the worst misfortune that might have befallen you. You might have been lucky enough to have just gotten through and gone out into life's great conflict illy prepared to properly fight the battle of life before you, for this is but the first skirmish-the real, great conflict is yet to come. While we applaud the victor and give him reward of merit, we sympathize with you, and advise you to cultivate your courage and perseverance, remembering the old injunction to try again. If at first you don't succeed, try, try again. Let your courage now appear, for if you will persevere, you will conquer, never fear. Try, try again.

I congratulate you that you have so satisfactorily concluded your studies, and in behalf of the Board of Trustees and Faculty, we bestow upon you to-night these credentials attesting our joint appreciation of your industry, your qualifications and your moral deportment during the past three years.

You have successfully fought the good fight and finished your course, that is, your preparatory course, for this is but the commencement of your careers. You now begin your life's work, commissioned to cure disease, and

with the beginning of this work, your real, practical, earnest study, commences. Henceforth, the industry and zeal you have thus far displayed, and of which these are your testimonials, are to continue; that is, if you properly appreciate the obligation you now assume in becoming physicians. Your efforts to accumulate knowledge to enable you to grapple with disease should never cease while you live.

We welcome you to the ranks of the toilers in a great and noble calling, at a period in its history when its record of work done has given it a glorious name. among men and made its votaries illustrious among the good and great in the world's history. While the work already accomplished has given our profession a place high in the esteem of the world's great philanthropic heart and discerning mind, there is work yet awaiting your personal performance that may make the names of some of you illustrious on the pages of its bright and brightening history.

Its

Three faithful years of earnest work have revealed to you something of the wondrous mechanism of man, the machinery you are commissioned to manage for the physical and mental well-being of your patients. wonderful framework, the skeleton, and superimposed brain and nerves, vascular, lymphatic and glandular systems and vital cavities have been brought to your view. You have been taught how beautiful, how wonderful, how complicate is man's organism. You began to realize how the Omnipotent Designer, binding nature fast in the fate of organic environment, has left free the human will, yet not wholly free, for the sphere of man's activities is limited save in the projection of his reflections, and yet even here a good or bad cerebral organism largely predestines the range and quality of his thoughts.

You are to aid in freeing man from the tyranny of weak or viciously constructed frames, and modify or avert the tendencies to, and free them from, the actual oppressions of disease, to regulate and strengthen their organic

forces, and modify or temper their surroundings to their normal organic needs. This is hygiene-the preventionand true therapy in the cure of disease actual, or disease impending, and health menaced by organic and extraorganic environment.

That dire Asiatic plague, which has on former visitations made devastating march through our land, failed last year to secure a fatal foothold on our soil. Our watchful profession was, by sight of science, enabled to discern its destroying intent afar off, and warily watching its devastation in the city of Hamburg and on its march across the sea, its deadly ravages were stayed.

Resistance to the next assault of the foe may fail, and our profession may be called upon, as in the past, to face and fight this deadly Eastern scourge, more fatal to life and national prosperity than the march of an invading army. Should it come, posts of honor may fall to your lot in the fight; some of you may be among "the yeomen of the guard."

We welcome you to a field which to the faithful and conscientious is the most profitable in rewards, though not in a pecuniary sense, of all the professions, save that of the Divine calling alone. Your vocation is to redeem, regenerate and disenthrall from disease that enslaves, oppresses and perverts both bodily and mental function. Misery alleviated, pain; mitigated and diseases cured, are your conquests and rewards.

You wish to be skillful; you wish to be prosperous; you wish to be successful in securing the approbation of mankind, and in getting suitable pecuniary recompense for your services. To do this, the same diligence that has characterized your pupilage must continue. In all your gettings, strive to get understanding. "Wisdom is the principal thing."

You must be manly and upright. Be honest and true to conscience and to God. You cannot be otherwise and make of yourselves reputable physicians. You have won the laurel of our approbation, you are yet to achieve