books or skilful friends cannot be consulted. Therefore, where do we need the best men, the best educated men, men with minds well trained in preparatory studies, men whose minds are able to grapple with facts at short notice, men with memories so well disciplined that the whole catalogue of disease, symptoms, and treatment will unroll themselves before their minds at a moment's notice, like a great panorama? Every preceptor and professor knows how much better a young man with a liberal education can pursue his studies, and with how much more credit he will pass his final examination, than the uneducated and untrained, other things being equal. Our land is to-day flooded with would-be doctors. The production exceeds the demand, and the result is patent to all-cheap doctors, patent medicine men, humbugs, quacks.

As consumption or need regulates the price of manufactured articles, so does it regulate the professions. Under such circumstances, in medicine, men will branch out into cancer doctors, abortionists, and into all kinds of quackery, for want of something better and more honorable to do. Raise the standard of our medical schools, encourage only such young men who have a liberal education to embark in medicine, and we will have fewer doctors, but the quality will make up for the quantity, and our undertakers will have less faults to bury under the clods of the valley. It is true, we have some in our profession to-day who stand in the front ranks, and who have had no liberal education; but tell us what would these have done, where would they stand to-day, if, with the same amount of application they could have had their minds previously well trained in an academy or college? I once knew a man who had no arms, yet could thread a needle or write, holding the needle or pen in his toes. Would you choose such a man for your clerk or secretary? Much less should a maimed, crippled, or uncultivated mind enter upon the intellectual professional studies, when, in medicine especially, by a slight error in judgment a soul may be sent unprepared into eternity. It is true there is always room up higher, but who are the ones who generally reach the higher strata? Is it the fledgling or the one who has grown to his full stature ? Is it the one who has an uncultivated mind in a sound body, or he who has "mens sana in corpore sano"? He who desires to gain a competent knowledge of medicine ought to possess a natural talent, favorable position for the study, early and thorough previous education and love to labor in his calling.

"No man is born into the world whose work
Is not born with him; there is always work
And tools to work withal, for those who will."

Again, the great number of our medical schools is a growing evil to the profession. All the schools make a special effort to procure the largest number of scholars, without respect to their qualifications or preparatory training. And at the final examination, many a young man is sent out into the world as a full-grown doctor, when he should have been fed on a milk diet for a year or two longer. But this would not swell the number of their graduates, which seems to give notoriety to the schools; forgetting that the character of the graduates has more to do with the success of an institution than mere numbers. We are told these half-made doctors will do for country practitioners. Now we claim we have equally as good doctors in the country as we find in our cities. And we need men in the country who have a good scientific training, more than in the cities. The country physician cannot apply himself to one branch of his profession. In serious cases he cannot call on a specialist, therefore he must be well versed in all departments of practice, in medical, surgical, and obstetrical cases. Dr. Green says: "If there is a difference, another letter should be added to the title of each graduate and we should have M. D. R.: Medicinæ Doctor Rusticus; and M. D. U.: Medicinæ Doctor Urbanus."

No doubt all schools require their applicants to read medicine at least one year under a preceptor, and on these preceptors they lay the blame, and justly too, for not sending students who have a good preparatory education, and a good moral character. It seems reasonable that the preceptor should be thoroughly acquainted with his students, as they generally are from his immediate neighborhood, and thus he is the more able to tell whether they are suitable subjects for the school of Esculapius or Ceres. You and I can point to cases where the preceptor has made capital of the number of students he has had the honor of pushing into the medical fraternity. But these men cannot point to many successful ones; quantity will not in this case make up for lack in quality.

Within the past year we refused two young men as students for no other reason but that of knowing that their preparatory education was very much neglected. A few years ago we were called in consultation with an old physician who did not know the difference between an acid and an alkali. Suffice it to say his preparatory education was wofully deficient, yet he held a diploma from a medical school. This same physician was some years ago the preceptor of a young man, who, being several times rejected, at last through great tribulation received a diploma from one of our best medical schools. To show this young man's training, he calls "pneumonia," "ammonia."

How many can you find, in this enlightened age, who can write an intelligible, much less professional, prescription? How many are to-day in our medical schools who have little or no knowledge of Latin, and much less of Greek? Yea, how many could be found who cannot write an intelligent letter, much less spell correctly some of the most common words in our language? If this is the case, and it cannot be gainsaid, and the schools pay no attention to our demands, where must we go to remedy this evil— this great wrong to suffering humanity-this premium for ignorance? To you, to me, to each and every one of the medical fraternity individually.

Prof. Tyler, of Amherst College, says: "Half educated fledglings are fluttering and tumbling into the practice of law and medicine more frequently now than at any former period of our history." Another requisite of a medical student and a successful physician is a good moral character, a religious character; for true morality cannot exist without piety.

Swift says:

"The system of morality gathered from the ancient sages falls far short of that delivered in the gospel."

Wilkins says: "From the nature of things I am morally certain that the mind free from passion and prejudice is more fit to pass a true judgment than one biased by affection and interest." We want men who do not pride themselves or rely solely on their external rectitude or virtues, but we want men who know and feel that the Supreme Being sees all that they do, and will have to give an account of all the deeds done in the body, who strictly carry out the great law of reciprocity, "Do unto others as you would wish to be done by." A hypocrite cannot possibly keep himself long on his guard.

William Heys, Esq., Fellow of the Royal College of Surgeons, London, took this maxim when he started out on his medical course: "I will spare no pains to qualify myself for that state of life to which the providence of God has called me, and then trust him with the success of my endeavors."

William Cook, M.D., Member of the Royal College of Surgeons, says: "If there is one condition in life more than another (subordinate, indeed, to the sacred office) in which a knowledge of theology, natural and revealed, is of personal and relative importance, in combination with all other qualifications for an efficient performance of duty, it is that profession which is appealed to and confided in, when the body is racked with pain, life jeopardized, reason dethroned, or a bereaved family are looking for solace."

No doubt in all large bodies of men there will be some who hold

very erroneous notions of religion, but we deny that the medical profession is more open to the charge of infidelity and scepticism than any other profession. Dr. Gregory says: "Medicine, of all professions, should be the least suspected of leading to impiety."

It is Christianity that will show charity to the poor as well as to the rich; it is Christianity that teaches us to "be great and seek little things; don't be little and seek great things." In the Hippocratic Oath we find these words: "With purity and holiness I will pass my life and practise my art."

Let us then as a medical society, as individual members of that society, from this time forward say we will encourage only such young men in our profession who have a natural talent for the art, and who are morally well prepared for it, and have a thorough academic or collegiate education. More than ever is it necessary for our medical societies to stand in a kind but determined opposition to the customs or fashions of the world, breasting the waves of ignorance like the Eddystone light-house.

Let us take up the watchword, "Go forward." Although we may see hosts of medical colleges behind us, and before us a large sea of the uneducated and untrained, let us obey the voice of suffering humanity and go forward," and this sea of ignorance will separate and we will come out victorious. Let us 66 open our eyes, or they may be painfully opened for us." Let us not be sleeping at the foot of Jacob's ladder, dreaming of better and brighter days, but let us awake out of our sleep and climb higher and higher, and press forward in this matter, until every medical college and university of our land shall make it obligatory upon all applicants to have a thorough academic or collegiate training.

PSOAS ABSCESS SIMULATING NERVOUS

AFFECTIONS.

By CHARLES K. MILLS, M.D.

NEUROLOGIST TO THE PHILADELPHIA HOSPITAL; LECTURER ON ELECTRO-THERAPEUTICS IN THE UNIVERSITY OF PENNSYLVANIA.

THE mistakes likely to be made in differentiating psoas abscess from other surgical conditions have been ably set forth by numerous writers; but as several cases of this affection, diagnosticated as disease of the nervous system, have recently come to my notice, and, as I have not seen the question of its diagnosis discussed from this standpoint, I have thought that it might not be uninteresting to briefly direct attention to the fact of it sometimes simulating certain neuralgias, paralyses, and local spasmodic disorders of the lower extremities.

CASE I.-W. C., a milkman, twenty-three years of age, five weeks before applying for treatment, while lifting a churn, had suddenly felt a sharp pain above the sacrum. For several days, owing to pain in the lumbo-sacral region, he was unable to straighten his back ; but about the sixth day after the injury, the pain moved to the front of the left thigh, where it had remained. According to the description given by the patient, it extended from Poupart's ligament to the inner side of the knee, along the course of the anterior crural nerve and its internal saphenous branch, being most severe at the lower half of the nerve. When the patient stood up or extended the leg he suffered severely, but, on sitting or lying down, he experienced considerable relief. The pain could also be lessened by flexing the thigh on the pelvis, keeping the knee bent at the same time. The easiest position was with the left leg crossed over the right knee; but to accomplish this he was obliged to lift the limb. with his hands, an apparent partial paralysis coexisting with the pain.

The patient was examined by Drs. John Ashhurst, C. T. Hunter, and D. Benjamin, in addition to myself. A slight tense swelling was discovered beneath Poupart's ligament, and to the outer side of the femoral artery. The case was decided to be one of psoas