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physiological chemistry of the nineteenth century, and published by the Sun four years ago. My medical ideal does much more. The loving connection between medicine and the world, between the profession and the public is not platonic, it is active. Being a conscientious citizen of the profession he feels his obligations as a citizen of the state and of human society. He will work for the consolidation of the profession, for the suppression of quackery and all other forms of infectious disease; for the improvement of our school system, our streets, our subways and water supplies, for the repeal of bad laws, and the introduction of good bills.

That is what your ideal medical man will do. Smaller men must be satisfied with performing only a share of it. But none of us here or elsewhere, has a right to shun common duties. Next to performing great tasks is for us who cannot reach the highest aims, the ambition to work in their service. Idea's are not reserved for those who walk on the mountain tops of human existence. No man or woman should be without a heart, nor without an ideal, and the sense of responsibility to the Commonwealth of which they form a part.

Doctor Osler! Have I involuntarily drawn some, or many, or most of the outlines of your picture, or have I not? I do not know, but I could not help while speaking, beholding you before my mind's eye. Still, being neither an orator nor a poet, nor a savant like yourself, I know my language cannot reach my aspirations nor your deserts. Do not explain, or excuse, or deny, either seriously or humorously. Your natural gifts you are not responsible for, so there is really no need of an apology. The life-long work you invested in your aims and ideals has ever been a labor of love and no hardship. You have not exerted yourself to earn thanks, and expect none. So when you enjoyed your incessant and fruitful toil, we have sympathized and profited. When you, fulfilling the obligations to science, the profession and the world, found inscribed in the innermost of your heart, added to the riches of mankind, we have admired and harvested. Your character and learning, your sound judgment and warm heart, your generosity and consistency have gained thousands of friends. Friends made by such as you are not of the every-day's stamp. There is nobody here or outside that came near you that has not been attracted, improved and inspired by you. These are simple statements in the plain everyday words of one who, being so much older in years than you, was glad to sit at your feet and listen to you, no matter whether you are heard in Montreal, Philadelphia, Baltimore or Oxford. sort of explanation of your intellectual growth and success, I have heard you speak of your indebtedness to favorable circumstances and to the influence of your descent. Be it so, for as your friend Thomas Brown, without, I believe, thinking of you, said three hundred years ago: Non mediocris felicitatis est ad virtutem nasci."

As a

(Sent. II, Par. II, p. 178 Merryweather-" it is no mean felicity to be born with the imprint of virtue." So your heirloom has actually become ours, indeed; and we take pride in it almost like yourself. What your father and your good old mother, who are often on your lips, have done to shape you, they have done for us also. Tell her we send her greeting and the expression of our reverence and of our wish she may, as we do now and ever, enjoy her son long after this, her ninety-eighth year, and of our gratitude to her, the British mother of one of the greatest benefactors of the medical profession of America.

Presentation of "Cicero de Senectute."-Dr. S. Weir Mitchell, of Philadelphia, then presented Dr. Osler with a translation of Cicero's immortal essay on old age. Dr. Mitchell said that the gift undoubtedly fulfilled one quality of the true gift, inasmuch as it was something that the givers would like to keep themselves. to the appropriateness of it there could be no doubt, and, indeed applause of the guests showed already that they realized its aptness to the occasion. One reason of this appropriateness is that Cicero must be regarded as an anticipatory plagiarist, since he had said in a famous passage of this essay, "It is very desirable for man to expire at the right time." As Cicero was probably about sixty years of age when he wrote this essay, he did not state as definitely as the newspapers claim the guest of the evening to have stated just what was the right time for a man to expire. As to his own selection as the presenter of the gift, Dr. Mitchell said he was the youngest man present, and was therefore naturally chosen to make the presentation, to the most venerable member of the American medical profession. It concerned a subject which the ladies never attained, and the translation had been made by James Logan, the friend and adviser of William Penn. The printing of this copy had been done by Benjamin Franklin, and it bears the date 1744. Franklin said very appropriately in the preface, that as it was only old men who would be apt to read an essay on old age, therefore the type selected had been especially large, in order that no straining of the eyes might remind them of how much the departing years were taking away from them. This was a story told by the kindly old pagan philosopher of the declining years, the declining years in the sense perhaps, that one is compelled to decline all the good things and yet find many subjects for consolation in the years as they go.

With a fervent "God bless you!" Dr. Mitchell made the presentation, and wished that Dr. Osler should find in the years as they passed only the renewal of the satisfaction that had been his in the friends and the influence for good of other days.

Dr. Tyson, in introducing Dr. Osler for the response to the toast, said that usually occasions like this and eulogies such as Dr Osler had listened to came to old men, and therefore had their

elements of sadness, inasmuch as they represented the farewell to the work of a lifetime. It is not the end of a career, however, that is celebrated to-night, but the entrance upon a new sphere of activity; and it is not "Good-bye" that is said, but a cordial "Aufwiedersehen," for it cannot be said that the medical profession of America shall not have the benefit of Osler's presence and of his genial oratory many times in the years to come.

Osler's Response.-Dr. Ósler said that he could not but feel that the happiness which came to him in the midst of all these manifestations of friendship was undeserved. He felt that he had been singularly blessed in the friends that he had made. He would yield to no man who claimed to have more or better friends than he had, and for this he can say, "God be praised!" If success consists in getting what one wants, and being satisfied with it, then, indeed, success had been his, since friends so precious have come to him. Always, however, there has been the feeling of lack of desert of the privileges that have come. When the invitation to present himself as a candidate to the position of clinical medicine at Philadelphia reached him at Leipzic, Dr. Osler was inclined to think that it must be a joke. He was not sure with regard to it until two weeks later a cablegram reached him to meet Dr. Weir Mitchell in London. Boston measures men by brains, it is said New York by bawbees, and Philadelphia by breeding. It was Mitchell's task to test his breeding. He did so by having him eat cherry pies and noting how he disposed of the stones. As Osler disposed of them discreetly, the breeding question was settled. Friends had spoken during the evening of his influence on Philadelphia. What he felt as one of the most precious things in his life was the influence of Philadelphians on him who have been the colleagues of such great men as Pepper and Leidy and Agnew and Ashurst, was of itself a liberal education in medicine, a suggestive influence in medical education and in teaching, whose power could not be exaggerated.

At Johns Hopkins there had come the opportunity to do for America what had been so well done in Germany, to make a great teaching clinic. If he has accomplished anything, Dr. Osler feels it is by the introduction of Teutonic methods into American medical education. He cannot but feel supremely thankful then for the opportunity for this that was presented at Johns Hopkins.

American Hospital Opportunities.-Dr. Osler said that even on an occasion like this he felt that he must say a word with regard to the hospital opportunities that are being wasted in America. In every town of 50,000 inhabitants in this country, there could be a good medical clinic from which would be issuing regularly distinct contributions to medical progress. For this, however, there must be a change in hospital equipment and methods of appointment. If a few men guided the destinies of hospitals instead of

many, and if they were not too often the bone of political contention, then much might be accomplished that now failed. There would have to be properly paid assistants who would remain as resident physicians at the hospital, not for a year or two, but for many years. If this were done, then America would accomplish more for clinical medicine in five years than Germany could do in ten.

Dr. Osler himself has cherished three personal ideas: Do the day's work well, to act up to the Golden Rule and to cultivate equanimity. To do the day's work well may seem too practical to be an ideal, but it is an ideal. To let the future take care of itself, and to do the thing in hand as well as possible, represents the only hope for the successful accomplishment of good work. The Golden Rule is an ideal only if it is applied, not alone to the professional brethren, but also to patients and to all those with whom one comes in contact. As for equanimity, it is the only thing that insures anything like happiness in life. Equanimity that enables a man to take success with humility, to enjoy even his friends with humility, and to suffer sorrow and trial without being cast down.

Dr. Osler feels that he has made mistakes, that they have been of the head and not of the heart. He has loved no darkness, he has sophisticated no truth. He has allowed no fear to paralyse his efforts. He leaves his friends with sorrow and yet with feelings of profoundest joy over their manifestations of kindliness to him and his, and he feels that the bonds, though loosened, are not severed.-Medical News.

Clinical Department.

A Case of Tumour in the Third Ventricle. O. J. KAUFFMANN, M.D., in British Medical Journal.

J. R., aged 40 years, was admitted into the infirmary on September 24th, 1904. He was comatose, and breathing deeply and stertorously, but could draw up his arms and legs in response to peripheral stimulation. The left side of the face appeared rather flatter than the right, and it was thought that there was slight weakness of the left eyelids. Temperature, 101°; pulse, 88; respiration, 28. The condition remained practically unchanged for twelve hours, until about 8 a.m. next morning, September 25th. In that period he had several times passed urine and feces in bed. The temperature had gradually fallen to normal. At the hour 'named, consciousness began slowly to return, and by noon he had recovered snfficiently to make rational replies to questions of a simple nature, though he had still much confusion of thought, was inclined to yawn, and, if left undisturbed, quickly dropped off into quiet, natural sleep. He had no recollection of the seizure on the previous day, nor of having been brought to the Infirmary. Temperature, 98°; pulse, 72; respiration, 24. Urine normal. Knee-jerks equal and moderate; plantar reflexes equal in extent and rapidity, and both flexor. No trace of hemiparesis, hemianæsthesia, or hemianopia, and no speech-defect. The tongue was protruded mesially, and there was no trace of facial weakness, either during rest or an exertion of the muscles. The patient was completely blind in each eye from early infancy, the cornea showing many opacities, rendering the pupils difficult of definition; they were, however, equal and rather small.

The history was as follows:-For twelve months before the apoplectic seizure above detailed, the patient had been continuously an inmate of the workhouse. Apparently there had been no reason to suspect any grave illness until September 24th, the day of his admission into the Infirmary. On that day he was noticed to vomit several times, but did not keep his bed. About 9 p.m. he was found unconscious and stertorous, and was transported to the Infirmary.

On September 30th, the patient having apparently regained his usual health, he was allowed to get up, and found his way about in his accustomed manner. Four days later, looking and feeling quite well, and presenting no vestige of paralysis, he was sent back to the workhouse. No definite diagnosis as to the cause of the apoplectic attack was made.

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