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ber of the student graduates. The prize for the highest general average, a set of Saunder's Medical Hand Atlases, presented by the publishers, was given to Albert Silverstein. The second general average prize, an obstetric bag, by the J. Durbin Instrument Co., was awarded to Claude E. Cooper, who also carried off the medical prize, a case of vials. Geo. A. Moleen stood first in gynecology, and received a set of surgical instruments, donated by Mr. W. H. Lauth. Wm. H. Rothwell captured the prize book on diseases of children, and also Dr. LeMond's gold medal for excellence in the study of the eye and ear. The competition between Rothwell and Silverstein for the obstetric prize was so very even that Prof. Buchtel gave to each of them a full prize, a check for fifty dollars. The banquet at the Windsor was an occasion of exuberant, but wholesome joy. The dean of the faculty, Dr. Thos. H. Hawkins, acted as toast-master. The toasts were responded to by the “old reliable” Prof. Elsner, by Rabbi Friedman, by Dr. J. N. Hall (surnamed “Ananias”), by Junior Ferris and “Billy” Rothwell. The latter's speech took the house with roars. And finally, they didn't go home till morning.

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Colorado College

The third annual commencement of Dental Surgery. of this thriving and well conducted

school took place in the ordinary of the Brown Palace Hotel, on Wednesday evening, April 25. The large room was comfortably filled with friends of students, graduates and faculty. The program was of proper length and was carried out very satisfactorily. The dean of the college, Dr. W. T. Chambers, gave a short and practical opening address. He was followed by Dr. Robert Levy with a forcible and comprehensive presentation of the relations between medicine and dentistry. He held that the latter profession is in reality a specialty of medicine, and that it should be taught in connection with a regular medical curriculum, either in the last year of the course or by way of post-graduate instruction. Dr. L. A. Walker delivered a sensible, semi-humorous valedictory. The degrees were conferred upon the eleven graduates in a few well chosen words, by President H. A. Fynn. Good music was furnished by Mr. Wortmann and the college quartette, comprising Messrs. Wallace, McGee, Walker and Scott. About 100 fortunate individuals partook of the bounties of the banquet that came next. Dr. H. W. McLauthlin made an ideal toast-master, and apt responses were made by Drs. Fraser, Dean, Hopkins, Hoffmann and Tuxbury, and Mr. Lewis.

Clinical All would agree that not the thousands Opportunities. of books that may be ranged on shelves

around him, but the books he reads add to the student's learning; not the herds he may look at, but the beefsteaks he eats and digests add to his strength. Still if one examines the common feeling about the advantages of attendance upon large clinics, he will find something similar to the belief that a man can become learned by looking at the outsides of enough books, or keep up his nutrition by walking through a provision warehouse.

It is not the number of cases recorded in the general statistics as attending a certain clinic, not the number glanced at so hurriedly that the features presented by one are promptly crowded out of memory by the next, that gives a clinical experience worthy of the

It is rather the minuteness and thoroughness of the study of the few cases that can be really grasped and mastered in a given time. In even the smallest clinics it is not usually the number of the cases, but the manner in which they are presented, or the limited capacity of the mind to grasp and assimilate new facts that limits the clinical opportunities.

For the practitioner of large experience, the large clinic may offer this advantage—the opportunity to study the rarer forms of disease; for which study he is


prepared by complete familiarity with the more common forms allied to them. If the advanced student can select, from the fifty cases presented, the one in which he is interested, and can study it exclusively through the clinic hour or hours, completely ignoring the other forty-nine cases as though they had never been presented, the large clinic offers a real advantage.

Still it is the one case only that counts; the others are at best as nothing. Too often they are far worse than nothing For one attracts attention to one point, another to another point, and so on until the time is frittered away without any real study, any real mastery of new phenomena of disease. The dissipation of a large clinic is very attractive to the medical man. But it is none the less dissipation; waste of time and energy, with impairment of the habit of study, and the formation of a habit of half-seeing a thing, to wholly forget it a little later.

But for the undergraduate student of medicine or the recent graduate, even with the best facilities that any medical school can furnish for contact with actual patients, for the student with only such a preparation the large clinic is an unmitigated evil. His knowledge just prepares him for this form of dissipation, and he falls an easy victim. He inevitably turns toward the rarer cases that he is not fully prepared to undertake, and from these his attention is distracted in a dozen different directions, while those in charge of the clinic are so busied with attention to the large numbers applying that their chance of helping the student is greatly diminished.

The most profitable clinical opportunities anywhere will be those that confine the student to the consideration of one or two or three new cases a day, with the necessary re-examinations of cases previously studied. This fact has been somewhat obscured by the usual location of the best teachers and most complete scientific equipments in the largest cities, where there are also the largest clinics.

In Germany, where this is not so generally the case, the fact that clinical advantages are not confined to the enormous clinics is strongly emphasized. The fame of the German clinics is world wide and serves to attract many students from America. But few of us realize how small are the cities in which many of the famous clinics are situated. In the Philadelphia Medical Journal for April 14th is given a list of the German speaking universities that have attracted American students for the last winter semester.

There are thirteen of them, and eight are situated in cities much smaller than Denver, as follows: Zurich .....

.103,000. Wurzburg

62,000. Freiburg

48,000. Heidelberg

32,000. Gottingen

24,000, Giessen...

21,000. Tubingen

14,000. Marburg

13,000. For another semester the list might readily include some or all of the famous universities situated in these cities: Halle............

.101,000. Kiel

69,000. Rostock

45,000. Bonn....

40,000. Greifswald

22,000. Erlangen

18,000. Jena ....

13,000. In each of these universities men have found the clinical opportunities which enabled them to build world reputations for original work. Some have permanently associated their names with these universities, while others, after doing their best work in these smaller cities, have come to be more widely known in Berlin or Vienna. Even for teaching the raw medical student or the new-fledged M.D. the common forms of disease, we may still expect the city of 400,000 to sneer at the clinical opportunities of the city of 200,

000. But to the well-informed the sneer should reveal a dense ignorance of the real nature of clinical opportunities.


Treatment In his new book on nervous and mental of Migraine. diseases, Charles S. Potts advises for the

attack rest in bed in a darkened room, stomach lavage with hot water or drinking large quantities of hot water. After this a saline cathartic or a teaspoonful or two of Carlsbad salts should be given and aided if need be by a hot soap and water enema.

Combined with these measures, antipyrin, a cetanild, caffein, salicylates or ergot may be tried. Mild galvanic currents to the head and static sparks are sometimes of benefit. In treating the disease, all possible sources (eyes, nose, digestive organs) of reflex irritation must be removed. The diet should be simple, excluding red meats and all articles easily fermented. Of drugs, cannabis indica, long continued to toleration, is most successful. It may be combined with arsenic or in case of a gouty diathesis with ammonium salicylate. Sodium phosphate or Rochelle salt before breakfast is also of service. The patient must avoid excessive mental and physical strain and lead a regular and outdoor life as much as possible.

Genito-Urinary The genito-urinary tract is normally Bacteriology sterile above the constrictor urethrae

muscle. Bacteriuria alone (excepting the proteus Hauser) will not of itself produce cystitia, according to John Collins Warren. There must also be a lowered resistance of the bladder wall, from various causes. The common type of cystitis is accompanied by acid urine, containing the bacterium coli commune, the tubercle-bacillus or the streptococcus pyogenes. “Ammoniacal decomposition is generally due to a mixed infection and is of secondary importance, but of itself it is not a direct cause of cystitis, although such a condition enhances the activity of many pyogenic

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