Okay, we're going to try and get started so that Dr. Mifflin can participate a little bit in the discussion this morning. Our speaker is going to be Adam Guess, one of our cornea fellows, and he's going to speak about fungal keratitis. Thanks. All right. So can you guys hear me okay? Is this our right volume? Yeah. Okay. So I think I know most of you. I'm Adam Guess. I'm one of the cornea fellows this year. And I'll be presenting a case that I took care of along with Dr. Mifflin. And this was an interesting case. I certainly learned a lot from it, so I thought it'd be interesting to you guys. So this is the, you know, so going all the way back, this patient has a fairly extensive history, but this was the first time we saw her. She's a 54-year-old woman who we first saw in 2010. And she has a long history of herpetic infections on the left side of her face dating back to first 18 months of age. And she ultimately developed this interstitial keratitis in her left eye. And when we first saw her, she was presenting for decreased vision in that eye, also some ocular discomfort. You know, on examination, we see corneal vascularization and scarring, some lipid keratopathy, and a fairly pronounced iron line. This lesion was, so first of all, the patient was put on a psychothermia to help try to control herpetic flares, but then this lesion was treated in the operating room with a cauterization of the feeder vessels to try to get these vessels to close down and perhaps limit her erythritic keratopathy. That didn't really help her vision very much. And the next thing that was done was to give her a subconjunction of penelope. Again, trying to get the vessels to close up. This, again, was not successful. She was also treated with subconjunctival abastin, again in the same area, to try to close up these vessels. But ultimately, the patient's vision did not improve very much. And over the course of the next year or so, she ultimately decided to undergo penetrating peritoplastia in this eye. So the graft was done. Her first graft, the surgery proceeded un-eventfully in place with 16 interrupted sutures. And as expected, the path analysis showed some stromal vascularization and some chronic ectinic keratopathy. The post-op course in this patient was difficult due to poor epithelialization. I'm sure that her neurotrophic nature as a herpetic keratitis patient played a role for sure. Particularly, there was this inferral temporal portion of her graft, her surgery. This required the use of bandage contact lenses and, ultimately, a tarsaurofi to try to get the epideffect to close and epithelialize. By post-op month three after this first graft, her epithelium was healed. She did have some residual stromal thinning, especially in that inferral temporal region of her graft.  This required off and on bandage contact lens use. Vega mox when she did have epideffects. She was maintained on preservative-free dexamethasone to try to prevent graft projection. And she was maintained on vouchrex to try to keep down any herpetic flares. By post-op month ten, she was doing pretty good. Best corrective vision was 2050, sutures were removed. And then coming forward to October of this last year of 2012, she presented with a red painful eye and had a new large epithelial defect sort of centered around the graft edge near this inferral temporal region. The cornea was markedly thin in that region and the tissue was generally kind of soupy. And basically it was a graft melt that she was experiencing. The graft melt was presumed to be herpetic in nature based on her history of herpetic infections in that eye. She was bumped up to her full treatment dose of acyclovir. She was given topical zirgan, Vega mox for the epideffect and maintained on her dexamethasone. During the couple week course of trying to treat this graft melt, she did develop lesions on her left scalp, which sort of confirmed the thought that this was a herpetic infection, that this was Oster causing this melt. Unfortunately the graft continued to thin and at one point it was so thin we were concerned that perforation was going to happen. So at that point a cynoacrylate glue was applied with a bandage contact lens over the glue. This bought her about a week, but unfortunately about five days later the glue did come off and I perforated. So this resulted in the patient needing to undergo an emergent penetrating keratoplasty. And at 8.75 millimeters so a larger graft place. And Tarsorophy was done at the end of the procedure to try to help prevent some of these epithelialization problems that she had had with her first graft. Following the second PKP, she actually did pretty well in terms of her epithelium. Pathologic analysis somewhat surprisingly showed fungal elements in the excised PKP graft. Cultures were done including fungal cultures at the time of her surgery and didn't show any growth. And the question at that time we had thought and still do I think think that this was a herpetic melt in nature. So the question is whether this fungus was sort of a cohabitant or whether it was at all contributing to her melting graft in that region. And again based on her history and based on those skin lesions we thought this was a herpetic infection leading to the graft melt. The patient following her surgery was actually doing pretty well. She was treated with Durazol, Vigamax. She was on a psychovir sort of a maintenance dose. And then at first using a bandage contact lens to help keep the epithelium in good shape. By post-out month three she was doing pretty well. Her epithelium was intact. The graft was clear. She was not using a contact lens at that point. It was still just on Durazol and a psychovir. So things looking pretty good at that point. Unfortunately about a month later, so this is now February, on a Saturday she calls in because her eyes red and she noticed a concerning white spot on her graft. She's a pretty savvy patient so she knew that that could be a problem. So I saw her over that weekend. And I don't have an image from that day. This is an OR image from a couple of days later so it's not the greatest image. But basically there was kind of whiteness right along the graft. It's sort of a white infiltrate in that whole region. And again that's the region where she had had all of her problems with epithelial healing over the course of her graft. In addition to the infiltrate she had a really intense AC reaction. At least three plus cells. When I first saw her there was no hypopion. Although a couple of days later she did have a hypopion. But probably most concerning she had what appeared to be a fungal ball or hyphal ball sort of floating in the anterior chamber. It's hard to see but it's basically in this region here. And it was sort of this thick circumscribed ball that was sort of adhering to the iris up in that region. So that appearance and the fact that there were fungal elements in the excise graft of course was concerned for a fungal keratitis in this patient. On that days then I performed corneal scraping and culture of this infiltrate. And started the patient initially on voriconazole fortified drops every hour. Oral flu conazole. And I also decreased the durazole from four times a day down to just once a day in case that was playing a role. Also just increased the acyclovir up to her full treatment dose in case her piece was playing a component of this. And this was just before and after I did this scraping. So a couple days later there was still no growth in culture. I guess that wouldn't be surprising if this were a fungus. But there was a lot of increased anterior chamber cell and fibrin. Perhaps due to the fungus proliferating. Perhaps due to decreasing the durazole. Perhaps less corneal infiltrate at that time. The natomycin was added. So natomycin was added to her topical voriconazole that she was already using. And then her oral agent was switched from flu conazole to voriconazole. A B scan done at that time that was a Monday. That showed no posterior involvement. At that time we felt like we really needed to get an isolate, get to know what was going on here. So repeat corneal scraping was done with repeat culture. And this was actually done in the operating room to try to get a really high yield of anterior chamber fluid. We wanted to see if we could get any fungal elements to grow out of the anterior chamber fluid. See if we were able to get that fungal ball out, which I really wasn't. And also to do a lot of PCR testing on the anterior chamber fluid just to see if there was any herpes viruses in the anterior chamber fluid. So then a couple of days later we did get a result. And it was in fact a fungus. A fungus called eulocladium, which was certainly a new one to my experience. Has anyone here had experience with eulocladium before? Okay, this was a new one to me. And I'll go over it's actually quite a rare cause of fungal keratitis, but I'll go over in more detail about it. But it's interesting, both cultures grew the same organism. So the one that was done on that first Saturday and the one that was done a couple of days later, both grew eulocladium. The anterior chamber PCR was negative for the herpes viruses. And then all the gram stain and bacterial plates from those two different days did not grow any bacteria. Did not show any bacteria. And these are just some images from that first excised corneal button showing some of the fungal elements that were identified. This is the susceptibility testing for that organism. You see here that they say there are no guidelines for susceptibility testing for this organism. It's a pretty rare cause of infection. We had at this time the patient on boriconazole, which is shown here, natomycin, which is a polyene. So I guess it may be similar to amphotericin B susceptibility. But during the course of the patient's treatment, she was treated with natomycin boriconazole at one point, amphotericin B was treated with oral fluonazole and oral boriconazole. She's been treated with a lot of different antifungals. About three days later, the patient was looking like this. Basically, the corneal infiltrate actually looked a little better, but the anterior chamber looked really bad. There was a lot of thick fibrinoid material in the anterior chamber, these sort of white fungal balls. This was that one that we first noticed, and then there was a lot of stuff along this area, too. It was suggested at this point that the patient undergo an anterior chamber washout to try to get some of this stuff out of the anterior chamber, followed by injection of amphotericin B and boriconazole. It's an interesting surgery. I have just a quick edited clip of this surgery. Dr. Mifflin performed the surgery. I wasn't present for this, but it was interesting for me to watch the surgery afterwards because just the thick tenacious nature of this fungal stuff in the anterior chamber, I had a lot of experience with these kind of fungus in the anterior chamber, but I was really surprised by how tenacious this stuff was, which I guess explains why it was hard to get that fungal ball out of the anterior chamber just by doing an AC tap that first time. So this is using the binomial of the tractor. You can get a sense that this stuff is pretty thick and adherent. This patient is fake, by the way. Here are just some of this stuff. Yeah, I got just one more little clip of this stuff coming out. I was just really surprised at how thick this was. So anyway, after that, the couple sutures were placed and the patient did, as I mentioned, receive that AC injection of the anterior chamber. So kind of coming forward to now, and I'm glad Dr. Mifflin's here to kind of comment because I haven't seen the patient recently, but per the most recent know, a vision's hand motions. There isn't much infiltrate I'm told and that she still has an epideffect, but it is healing. The anterior chamber looks a lot better and I think she did have a tarsorphy, but now, is the tarsorphy now taken down? No, it's not. Okay. And she's being maintained on now just for conizol four times a day, oral flu conizol, the durazol, vigamox, and a full dose of sycovir. I want to talk a little bit about this specific fungus, but Dr. Mifflin, do you have any comments on the patient or on her care so far? So I want to talk a little bit about this organism because this was certainly a new one to my experience and kind of interesting the more I looked into it. Eulocladium is a filamentous fungus and it tends to be most specifically in the soil and in any kind of decaying or herbaceous plants or agricultural materials. It's also been isolated from papers, textiles, wood. And you know, and the interesting thing, traditionally this organism is considered to cause human disease. It's often considered to be contaminant when it does grow on various cultures, but that view is changing a little bit on this specific organism. And I have some papers to support that. In this case, we don't think it's a contaminant. The same organism grew on both cultures and this was presenting like a fungal carotidus and there was no bacterial growth on any of these cultures. So we do think that this actually did cause her carotidus. And I do have a couple other papers that mention this specific organism causing carotidus. In fact, it's one of the few types of infections that this organism has been reported to cause in immunocompetent patients. One interesting thing about this specific fungus is that because of its non-pathogenic status, it's often used to control them. It's been widely identified in many countries as a result and in fairly high concentrations. So this is an organism that you can pick up or I guess isolate just about everywhere. This was a paper from the Annals of Agricultural and Environmental Medicine and they had pages of tables showing various places that this organism has been discovered in various countries. But I just wanted to point out some of the places in the USA where they've identified this organism. So you see here paint ships and living rooms, carpets, bedspreads and furnitures, floors and home. So this is a pretty widely distributed fungus. You know, it's interesting. I guess the fungus thought to sort of induce plant defenses and that's the reason that they use it to help try to control plant diseases. It also is a competitive inhibitor. It kind of eats some of the same stuff that certain plant diseases eat. So that's why they like to put it on agricultural products. So traditionally, as I said, it's considered to not have pathogenic potential, although, you know, for a while it's been identified in immunocompromised patients causing skin infections. But then more recently there have been increasing reports that it can cause infections in immunocompetent patients. It causes nail infections. This is a report of a sinusitis that was caused by eulocladium. And then as I mentioned, there is a report here of a keratitis happening in immunocompetent patients. I'll go over that in some more detail. So that report is from Bad Knock et al. 2005. And this was a case of an Australian truck driver, a 43-year-old truck driver who really had no prior ophthalmic history and really didn't have any of the risk factors for a fungal keratitis. He had no trauma and no contact lens use, no steroid use. Developed a keratitis. It was initially transferred to a different center where they cultured him and ultimately accrued eulocladium. The patient was then treated with, let's see, hourly fluconazole and natomycin. It was a slow improvement. I mean, it took 24 days for this small ulcer to heal, but ultimately it did heal and he just had a scar left behind and had best-corrected vision of 2020. So this patient did pretty well. They did gene sequencing of the organism that grew and it's interesting. You notice five different species here that are considered 100% or 99.8% sequence similarity. There's a lot of nomenclature problems with this specific organism and a lot of people think that a lot of the different species that are listed are actually just maybe one species. So that's why I think when the microbiologists played it this out, they just called it eulocladium species rather than identifying it. But this was a microbiology journal and they thought that the appearance under the microscope was most consistent with eulocladium atrium for what it's worth. And here's a picture from their paper. This is their organism that they isolated on scraping from their patient. This is our patient. This is from the excised grafts. You see some similarities there. You know, as I mentioned, their patient didn't really have any risk factors for fungal keratitis. He did have a history of tinea pedis and was applying for a result only meant to his feet, so who knows if that's right. But otherwise, not your typical fungal keratitis patient. I did find one other case. I found this looking through my caranet, the corneal email list. And this was a paper published by Marianne and Frank Price and others looking at using collagen crosslinking to treat various different types of infectious keratitis. And they had, you know, they had various pages of tables of different organisms that had been treated. And one of the organisms was eulocladium. This was a 18-year-old female with a pretty small ulcer. You see that the max diameter was just 1.5 millimeters. And the patient recovered quickly after the crosslinking treatment. I did actually email Marianne Price to ask her if they have any more information about this patient or any more information about this organism. And she said, you know, not really. You know, this patient got better quickly and it's not a commonly encountered organism. But we have a couple of papers suggesting that this organism does cause keratitis. And this case, I guess, would be the third reported case as far as I can tell of eulocladium keratitis. One of the questions I had going through my mind as I was researching this stuff is, are fungal infections increasing? You know, in the news a lot lately has been all this stuff from the New England and it's interesting that in their case this organism was another one of these rare human pathogens, you know, that there was only 33 cases reported in the literature prior to this big outbreak. So this was another case where one of these sort of non-pathogenic or rarely pathogenic organisms was causing a lot of human disease. Fungal keratitis in general, the incidence varies widely based on where you are. This is a report from the Proctor Foundation and it just summarized various different other reports talking about the incidence of fungal keratitis. It could be as high as one-third of Miami whereas in California it's probably less than 10%. You know, a study from Madurai India at Aravind showed that pretty much 50% of their cases of keratitis are fungal and nature there. So geography plays a big role. I stumbled upon this paper from Nature when I was researching and it was interesting.  So what are, you know, new plant and animal diseases that are appearing? And it's interesting that in their tabulated graph here, you know, the huge portion of it, this red part, is fungal. And in fact they break down into 20-year periods here and you see that the incidence of fungal of new fungal infections is increasing dramatically. Who knows if we're just getting better at discovering them or maybe the antibiotics that we're using everywhere are somehow increasing the incidence of fungal infection. This is just the various places where these new fungal infections are appearing. You know, and along these same lines there was this paper from LV Prasad, I Institute in India talking about micro-spiridia, which is again one of these sort of opportunistic or what's classically thought to be an opportunistic fungus. And in their study they found that basically one out of five patients who presents with an infectious keratitis was micro-spiridia. So again suggesting that perhaps some of these organisms might be more common causes of keratitis than is traditionally thought. I wanted to back out a little bit and talk a little bit about just risk factors for fungal keratitis so we can have our clinical suspicions appropriately raised. And this patient basically had almost all of these risk factors. That's the reason to have a high suspicion for fungal keratitis in this patient. We had bandaged soft contact lenses coming on and off the eye. She did have a history of penetrating keratoplasty and I think a lot of this would be on. She did have ocular surface problems. She had chronic epithelial defects that we kind of heal and then we appear again. The patient didn't really have any trauma per se but these are basically the risk factors for what can predispose to a fungal keratitis. In case I'm sure you're all aware but this renewed epidemic was the moisture lock solution that was contaminated with fusarium in 2006. So the medical management of fungal keratitis is challenging. We really don't have an ideal drug to use. The ones that we do use tend to be poorly soluble and tend to be low potency so we need to really increase the concentrations to make them work. And there's a pretty high variability between in vitro and in vivo sensitivity and the other problem is that these fungi can become resistant. Furthermore when you increase the concentrations up enough to have an effect that can often become toxic to the cornea. So we're going to be fortified for Econosol to tell the pharmacist how to make it. I noticed that over the various papers with time the concentration of what's being used has increased like 20 fold from when it was first used. So we're using fairly high concentrations of these antifungals. But the main ones we use typically would be amphotericin B, natomycin and for Econosol. And the types that are used is going to vary by center. There was one study from Mass Eye and Ear and I think natomycin is probably the most widely used just because it's commercially available. And 70% of people who treat fungal keratitis will give the patient an oral agent as well. These are the oral agents that tend to be used. There aren't a lot of studies comparing the antifungal agents and in fact there was a recent Cochrane database review suggesting that there weren't enough randomized control trials to make a big difference. This is one randomized control trial that was done at Aravind Eye Hospital in India. And it was 120 patients. They have a pretty high incidence of fungal keratitis there. Most organisms in their series were fusarium and aspergillus. And basically they found no statistical difference between natomycin and boriconosol. It's interesting they didn't note a nonsignificant trend and by that I mean the p-value was 0.07. So almost significant towards better treatment of the natomycin. And then the other issue they looked at, a lot of people had questioned whether repeat scraping of fungal ulcers results in better healing. And there was a nonsignificant trend meaning p-value of 0.08 suggesting that the ultimate vision was worse with repeat scraping. I did also want to mention one paper talking about surgical treatments for fungal keratitis. It's unclear if this patient will ultimately need a surgical treatment for it. Talking about doing penetrating keratoplasty for, they really included all infectious keratitis. So in their series, for example, 58% was pseudomonas but 32% was fusariums. They did have a fairly high incidence of fungal infection. And basically in their series, people who had ulcers affecting the whole cornea, ulcers encroaching on the limbus were treated surgically. And it's interesting in their series also, so first of all they did large grafts because they tried to get around all of the infected material. And a lot of times they did what's called scleral keratoplasty where they basically saved one quadrant of limbal stem cells and then on the other quadrants they go all the way to the limbus. It's interesting that in their cases of fungal keratitis, they didn't use any steroids for the first several weeks, first one to three weeks, and they did use anti-fungal agents during the first one to three weeks after surgery. So that's something that was not done in this case potentially given the patient anti-fungal treatment as she was recovering but from her keratoplasty. These are just their results. It's kind of a long survival curve, but in essence the one year survival rate for these fungal cases was 72%, that means graft survival, which is pretty good considering that a lot of these cases were perforated or impending perforated. And they did mention in their article too that while the bacterial recurrences tend to happen within days of the graft, fungal recurrences often took weeks or months to show up. And when they did show up, they tended to be kind of an indolent, sort of an endophthalmitus type picture, which is not unlike the way our patient was presenting. So in summary I wanted to present this case because it's a rare cause of infectious keratitis. As far as we know this is only the third case of eulogladium that's been reporting. And fungal keratitis itself is rare, but there is some suggestion that perhaps fungal infections are increasing. I just wanted to also review these risk factors just so all of us can have them in front of our mind. Prior penetrating keratoplasty, any kind of non-healing or chronic FED effect, topical steroid use or soft contact lens use which this patient had all of these. And just I wanted to reiterate the importance of suspecting fungus and not being afraid to culture in these cases. Thanks. Any questions or comments? Oh, uh, several dextrose. Uh, the way the, the way the culture of the fungus. Mm-hmm. You know, maybe Dr. Moshvark can comment on this. When I was in California it was but what would be around our candidate I guess would be another. East, yeah. We see and we take our Boston to see what it would feel like. Thanks. Oh, are you? Yeah, I mean, I could, let me know. The what? Yeah, I mean the LASIC ones. Yeah, thank you. Sounds good, thank you. Yeah, we have two. So, I mean we have the one post-LASIC patient. Run-ups. Yeah. Maybe we should do we should do the LASIC ones. Yeah.


Would you like to have more fairness in the world and at the same time make a profit? Then you're going to enjoy the next three minutes where I'm going to give you the why how and what of breaking the wall of unconscious biases First let me tell you why we have a problem unconscious biases Prejudice think that makes us favor one thing irrationally over another They get created because we like to take shortcuts For instance Daniel Kahneman has shown in some of his documentation the Nobel Prize winner that we seem to have two systems installed in our brain System one is basically a reflex why it leads us to a quick and sometimes wrong conclusions System two on the other hand Texts us down the road of long hard rational thinking so guess which one became the basic standard setting Now system one has its benefits, but as the social sciences show it causes us to make mistakes An example is that an essay which was signed with a boy's name will get a higher grade than when the same essay is signed with a girl's name in Denmark a job application signed with a Middle Eastern name needs to apply for 52 percent more Precision's then with the same application is signed with a Nordic name We all make these mistakes Because system one is stopping us from being fair from hiring the best employees From supporting our greatest talents and that is costing us money For instance McKinsey said it made reports that show that one of the key indicators of innovation and growing revenue in businesses today is diversity in staff But system one is stopping us from using that very system So how do we break it? Well one way is to be conscious of when we're in system one and then know how and when to move into system two It's hard, but it's doable What we need to do is start training ourselves so that we know Understand recognize what system one is doing to us That's a way to fight our unconscious biases And that's where I get in I Have 15 more months of research ahead of me and I plan to use them I'll learn as much as I can so that what I'm done I can start doing unconscious bias training in Denmark something that nobody does I'm gonna do this because in Denmark we need a society to grow we need to prosper and Definitely, we need the will to be more fair And I want to contribute to that by breaking the wall of unconscious biases Thank you very much


In this video, we're going to review the ideas of changing the amplitude in the period of a sine or cosine wave and actually combine them together. So recall that if we have numbers a and b, which for the sake of the moment, we're going to assume b as a positive number. If you consider the graphs of y equal a times sine of bx or y equals a times cosine of bx, then this coefficient in front determines the amplitude of the sine or cosine wave. In fact, the amplitude of sine or cosine will be the absolute value of this coefficient that sits in front. If that number is positive, then no reflections happened, but if that number was negative, the amplitude will be its absolute value, but the negative in front will cause the graph to be reflected across the x-axis. So you should have to pay attention to that. Now with respect to b, it turns out that b is this number inside of the function, it's inside the sine or cosine. This affects the period of the sine or cosine function. In fact, the period will be p is equal to 2 pi over b. 2 pi is the standard period and the factor of b has adapted, has modified the length of the period, elongating it or compressing it. But why does b have to be positive? Well, could b be negative like a is? Well, the answer is that if b is ever negative, we can fix it because of the symmetry identities we introduced previously. So if you had something like y equals a sine of, say, like negative bx where, again, b is a positive number. Well, because sine has the property of y, I should say sine of negative x, sine's an odd function, so this is equal to negative sine of x here. So if you have a negative sine inside of the sine, you can actually bring it out. And so you end up with negative a times sine of bx right here.  Well, with regard to sine, excuse me, just sine, if we with regard to cosine, if you have y equals a times cosine of negative bx. Well, the thing to remember here is that cosine of negative x is actually just equal to cosine of x itself. Cosine's an even function so that negative doesn't affect anything. So you can just discard that negative sine, a times cosine of bx. So use the symmetry identities to deal with having a negative inside of the sine or cosine function. So we don't have to worry about it affecting the period whatsoever. No reflections across the y-axis is necessary here. So let's look at an example of this. Let's consider graphing the function y equals 2 sine of negative pi x. Well, you have a negative inside. Just like we said a moment ago, you need to bring that negative out in front. And so we end up with y equals negative 2 sine of pi x. So let's see how this has affected the graph of things. So because we have this negative 2 in front, it turns out that the amplitude of the function is going to be 2. And because of the negative sine, we're going to have a reflection across the x-axis. Let's keep that in play there. Because of the pi in front, it turns, excuse me, the pi inside of the sine function. The period of our function is going to be 2 pi over pi for which the pi's cancel out and we get a period of just 2. So they ask us to graph the function on the interval negative 3 to 3. Now notice how long that interval is. You have 3 minus a negative 3. This is equal to 6. 6, of course, is 3 times 2. So it's asking us to graph three cycles of this function. So if we can graph one cycle, then we can just copy it for the other ones as well. So it makes sense that we should just graph it first from 0 to 2. Right? That's going to be the standard thing we want to do. Let's graph it from 0 to 2, because that's one full cycle. And then we'll just copy and paste for the other bits of the pieces as well. So when it comes to graphing a sine or cosine function, you want to think of the five quadrantal points. That is these angles that change the quadrants. So you want to think of 0, pi halves, where am I at? Pi, 3 pi halves, and 2 pi. Where happens to those points? Well, when you change the amplitude, when you change the period, that's going to affect some things. So for a standard sine wave, you should be 0. You're going to have 0 at 0. You have 1 at pi halves. You have 0 at where we at pi. You're going to have negative 1 at 3 pi halves, and then you get 0 again at 2 pi. But things aren't like that. We've changed the period. So notice that these are still the five points we want to use. They're equally spaced. So these points are going to be 0, 1 half, 1, 3 halves, and 2. So we basically just forgot the pi's. Oh, that's because we canceled the pi out earlier, and so our period is just a 2. So we have the five points we need. These are our five quadrantal points with our modified sine wave here. What are their amplitudes? Well, x intercepts don't get changed by this stretching. The amplitude is now 2, so things should be reflected. Not 1. Excuse me. They should now be 2. They got stretched. So we get something like this. So it's tempting to say this is our basic picture right here. But nope, we have to also remember the reflection. So what was positive now becomes negative. So because of the reflections, we end up with a point down here at negative 2. And then we have 1 up here at positive 2, like so. And if we connect those dots together in the typical sinusoidal fashion, this would be what our picture looks like from 0 to 2. That's one cycle. We want to go all the way to 3. So we need to continue our picture here. So just by copying and pasting, we should have a negative 2 here. We should have a 0 there at 3. So we need to go all the way up to 3. We have to also go down to negative 3. So again, just copy and paste this picture over and over and over again. Just repeat this pattern. So that gets us to negative 2. We have to continue on to negative 3. And so just connect these dots in the usual sinusoidal way, like so. And so this would be the graph of sine of 2, excuse me, y equals 2 sine of negative pi x from negative 3 to 3. But it turns out we can go the other way when it comes to graphing these things. We can actually be given the graph and asked to come up with the formula that determines the graph. So what we're looking for is a function of the form y equals a sine of bx. Or we take y equals a cosine of bx. It turns out there are some options, but without considering type of vertical or horizontal shifts, this one's going to look like a sine wave. Notice how it starts at the origin, then you come up to its maximum, then back to an x-intercept, down to its minimum, then back to an x-intercept again. And so that's one cycle of the graph you see right here. This is one cycle. So there's some information we can glean for that. First of all, we see that the period of this thing is going to be pi. So illustrating that observation right there, we get that the period is going to be pi. We'll come back to that in a second. What about the amplitude? How far above this middle line, this midline, can we get? Well, the distance we go above the midline, it looks like it's a 3. So we'd say the amplitude is equal to a 3. But is this thing a sine or a cosine? Well, sine starts on the midline, it goes to a max, then it goes to a min and repeats itself. That looks like a sine to me. A cosine on the other hand, cosine starts at the max, then it goes towards the midline, then it goes down and things like that. So are you starting in the middle? Are you starting at the extreme? Since you start in the middle, it turns out that we want to model this using a sine wave. So is there any reflections going on? Well, no, sine starts off by going up. So there's no reflection. So the reflection is now banned. No reflections are allowed on this graph. And so with the information we have, we can start graph or we can come up with a formula, right? We get y equals 3 sine of b. Well, we don't know what b is. We know what pi is. So we saw earlier that pi, excuse me, p is equal to 2 pi over b. So we know the period and we can compute the period if we have b. We have to go the way around. But guess what? We can times both sides of this equation by b so that these are canceled. And we can divide both sides by p. So those are canceled. And we end up with b equals 2 pi over p. So there's this inverse proportionality between b and p right here. And so we see that if the period is pi, that means b is going to equal 2 pi over pi. The pi is canceled. We get 2. And so we should then record this as y equals 3 sine of 2x. And this function right here would graph the function that we were given. Let's do one more example of this. You can see this right down here. We have one cycle of a graph, a trigonometric function is given. Can we come up with a function formula for this thing? Well, let's first decide. We want sine or cosine. This thing feels like a sine to me because the midline, the line that runs through the middle of this thing is right here, our midline. And since we start on the midline like this, we would call this a sine wave. So this looks like a sine. But notice how we're decreasing first, not increasing? That tells me there's some type of reflection that happened to my sine wave. So what I'm expecting here is y equals negative a times sine of bx. We then have to find a, we have to find b. A is going to be the amplitude. How far above the midline can we go? It looks like the amplitude here is going to be 5. The next thing to determine would then be our period. How long does it take to complete one cycle? So we can see that the period is going to turn out to be 8 pi, like so. Now, to go from the period p to the coefficient b, we have to take an inverse proportion b is equal to 2 pi over p, the period. But the period is an 8 pi. The pi's cancel out and this simplifies just to be 1 fourth, like so. And so we end up with our final form, y equals negative 5 times sine of 1 fourth x. And so this is then the correct graph. So understanding periods and amplitudes helps us to graph trigonometric functions given their formulas. But we can also take a trigonometric graph and look at its formula. That is look at the graph and get the formula as well.


So over the next three weeks we are going to be talking about the documents of the church and let me give you some background as to why we're doing that and then maybe some direction with how we're gonna move forward in the coming weeks during the Sunday School class as you know, we just finished our series on union with Christ, which I thought was really really good and I hope you were blessed by that series It was a joy to be able to go through that in our Sunday School hour And so coming up now though what we plan to do during Sunday school is coordinate our Sunday School teaching with the teaching that goes on on Sunday night on the essentials of church doctrine and practice So as you know, we've switched things up on Sunday nights. We've moved from doing the essentials series on Sunday mornings To part two in the essentials series now dealing with the church our doctrine and practice on Sunday nights And the way we're you know framing those as one subject one sermon one hour on those Subjects essential to the life health growth of the Christian and in particular now Our study on the church church doctrine and church practice so to coordinate with that we like to try to coordinate our studies if possible so that you're We're covering one subject more broadly over several different teaching points in the church Helps us to retain those things a little bit better a little bit easier when we do that Gives you a good immersion into whatever subject it is that we're covering And so we want to try to coordinate now with Sunday school on Sunday morning So our plan is is during this hour is to do a series on the church and not just Maybe a basic series on the church but a series that will enable us to cover some subjects that we really feel like are critical and important at this point in time to be covering and so one of those Or one section of that study during the Sunday school hour will be on the regulative principle of worship So what I'm anticipating for that may be five or six weeks on how to think about the regulative principle How to apply the regulative principle how that applies to both our doctrine and our practice our worship and our functions here at The church, so we'll talk about that some but then I think we will attempt to start a relatively Lengthy or longer study on the relationship of church to state and we'll talk about the relationship of the church to our government the role of the church the role of the government the The authority of the government the authority of the Lord's Church The priority of Lord's Church the relationship between the two and what I think we will get into with that is what we're what we would call a theology of public life or a Theology of politics or a theology of Christian resistance Which I think is going to become increasingly important as time goes by this is something that we as a church are going to have to Understand understand well, and we want you to be thoroughly and well equipped with how we Understand those things and so we'll look at several texts in the Bible. We'll look at several subjects, you know a little shot across the bow If you will where the mask ordinances or the mask mandates Not too long ago here that we're dished out by our county in our state our country and there's more of that coming so we want to Help you help ourselves become well prepared as we see those things increasing many of you may have heard last week the pastor in Canada that was arrested apparently still in jail separated from his family over this issue of worship and so the the people of God need to be prepared for The persecution that's coming the difficulty that's coming as we want to spend some time doing that We'll also get into the church and social justice So in other words when we think about that that a series on the church that's sort of along the lines of what we're thinking In particular a bit of time on regulative principles not something that we ordinarily get to spend a good bit of time on I think that'll be really helpful to you, but then into a theology of Christian resistance or a theology of public life theology of social justice and so we'll Talk about that more as we go so we begin this morning though We thought would be helpful with the documents of the church We've come now to I know Pastor Dale the guys working on the essentials class are getting to the end of their first rotation with many of the Folks who are candidates for membership involved in that class and so the last three lessons are from really from part three In this new essential studies that will be rolling out soon that deal with Specific issues related to membership three of those are the documents of the church and when we say documents of the church We were thinking of Constitution Covenant and Confession right Constitution Covenant and Confession I didn't do that alliteration that was laid out for me That's what they're called a Constitution confession and and Covenant thank you already forgetting so we're gonna be talking about those three documents over the next three weeks and we'll do that For a few reasons one is that these Documents in our church really are living documents. They are not dry dusty Microsoft 98 Things that we keep in a file or put on a shelf somewhere These are documents that we use we refer to on a regular basis They are very important in the life of our church and so we want you to be well familiar with those documents We introduce them when someone comes for membership We spend some time talking about them and in some sense as we do rely on you to Understand to those and to read those to be familiar with those as we conduct church life around here But this is a good opportunity for us to spend a little bit of time on each of the three of those documents And I think as we go through that you'll see the reasons why that's important Practicality the practicality of those documents Requires regular review requires us to regular Regularly refer to them and so you'll hear us in our church regularly refer to our confession of faith We often do that during sermons in particular the essential sermons on Sunday night now You'll hear us do that during the essentials classes during Sunday school You'll hear us refer to our covenant on a regular basis and the members here will know That during membership matters for example, we're reciting our covenant together every single time we meet It's a document that has significance to us and it should and we need to be reminded of that the one that is probably Least familiar to you and maybe sort of least Out in the open so to speak and our practice as a church is the Constitution But the Constitution is a framework by which we do many of things that we do and very intentional document And so I pray it'll be a help to you this morning to review that We also have many new members many new attenders in our church many new Perspective members and we thought that a review of our documents in this way would also help them as they prepare for membership so our objective then in Talking about the documents of the church beginning this morning with the Constitution will be one to review the basis For their general use. What is the Constitution for? Why do we have one? We'll review the basis for their general use. We'll review the reasons for their specific form Why does our Constitution take the form that it does what purpose does it serve? How do we employ it and then we'll provide an overview of their basic content will look given the time left We'll look at the basic content of those documents and review that together. Okay, so those are our three objectives We're going to review the basis for their general use We're going to review the reasons for their specific form and then we're going to provide an overview of their basic content and Frequently at our church. I get questions on a regular basis about some matter in our Constitution. I think more frequently what we get is Questions related to the use of church covenants where church covenants come from why do churches use them? Are they biblical and what is their biblical basis? And so next week we're going to deal with Covenant and we're going to look at a Baptistic background a biblical background for the use of covenants and that's going to be really helpful and then we'll get an overview of our Confession three weeks from today. Okay, so if you need them, we have these Documents Nikki was very gracious to help us lay these out and we've got these copy lead to copy them I think yesterday and we've got these at the welcome desk for you So it'd be good for you to have a hard copy in your hands. That's available to you But also let me make a shameless plug for our church app I don't have my phone with me, but if you download our church app At the bottom of our home page on the church app There's a little resources button and if you click on resources then under resources if you click on members Right up front on that members page in our church app. You'll see Constitution covenant and confession and it's all laid out. It's laid out with hyperlink So you can go to our table of contents you can click on whatever aspect you want to look at It'll take you straight to that page in our Constitution or in our confession It really really excellent the way that Eggers laid that out and really helpful So I want to encourage you we have these handouts these outlines available So if you need one of these maybe the brothers can pass those out Josh is coming around with Constitutions then if somebody wouldn't mind grabbing a stack of outlines these outlines are available to you also help you follow along Okay, let's begin. We're talking about this morning then the cornerstone Constitution the Constitution of our Church, thanks brother Okay, when we think about heading number one then the basis for its general use What is the basis for the general use of a Constitution? Why do churches have constitutions? First, I think this is really important is necessary church order Necessary church order the use of a formal and legal document called a church Constitution arose in response to the need for Increased order in the Lord's church in the local church in the local body of believers And we begin with that premise that the Lord's church should be in order from scripture We find that in scripture in several places 1st Timothy chapter 3 verse 15 We as believers should know how we are to conduct ourselves in the house of God Which is the church of the living God the pillar and ground of the truth as we learn To understand how we are to conduct ourselves in the household of God, which is the church of the living God Obviously, we take all that we understand all that we know from the Bible and we apply that to church life And that's how we're to understand how we are to live with one another in the church but where constitutions where covenants where confessions have come from really is a systematizing of Those scriptural principles scriptural commands. It's a systematizing of what the Bible teaches and Arranging that in an orderly fashion so that it's easy for us to see and understand as we apply it directly to church life And so that's where a confession a constitution a covenant comes from we'll talk about that more as we go Okay, let's talk about the general basis then our general biblical background and to do that turn with me to Colossians chapter 2 Let's just take a look at a couple of texts All right, we're talking about the basis for its general use the basis for the general use of a church constitution and where that came from Colossians chapter 2 and beginning in verse 1 as Paul writes here just like in Rome as we're going through our series on Romans and Sunday morning Paul greatly desires to visit this church in Coloss he greatly desires to visit the Colossians And so he so it says he gives a purpose for that visit in verse beginning in verse 1 consider this purpose with me Paul says for I want you to know What a great conflict I have for you and those in Laodicea For as many as have not seen my face in the flesh so that here's the purpose statement right verse 2 so that one their hearts may be encouraged being knit together in love to Attaining to all the riches of the full assurance of understanding and Three to the knowledge of the mystery of God both of the Father and of Christ in whom are hidden all the treasures of wisdom and knowledge So Paul wants to visit the Colossians visit the church at Coloss and he wants to do that for three purposes Their hearts may be encouraged They may attain to all the riches of full assurance and understanding and three They may attain to the knowledge of the mystery of God both of the Father and of Jesus Christ in whom are hidden all the Treasures of wisdom and knowledge but then he gives a Theological reason for his visit Verse 4 now I say this lest anyone should deceive you with persuasive words in the words Paul wants to come Visit them Paul wants to teach because Paul knows that false teaching can take root in the church And he wants them to avoid deceitful traps of the false teachers that Paul has already mentioned in this letter Okay, but then there's a personal a personal reason also verse 5 For though I am absent in the flesh yet I am with you in spirit rejoicing to see your good order and the steadfastness of your faith in Christ all right, so Paul absent we're gonna talk about tonight in the sermon this evening about the communion of the saints But that's what's going on here with Paul and these believers at the church in Colossus What's going on with Paul and the church at Rome in Romans chapter one right? There's this spirit-wrought communion of the saints that exist between believers based upon his spirit Based upon what we believe and why we believe it based upon the work of the spirit in our hearts that unites us together in love Unites us together in faith. We're in union with Jesus Christ and by virtue of our union with Jesus Christ We're in union with one another and that's that's that Heart Reason why Paul longs to go and see them why he wants to be with them right he is with them in spirit That's exactly what Paul's talking about is the communion of the saints and he's rejoicing now What is he rejoicing in with respect to them? He's rejoicing in their good order and the steadfastness of their faith. That's interesting isn't it? Good order and steadfastness of faith the word for order is Toxis Toxis orderly conduct the word for steadfastness the steadfastness of your faith is Stereo Oma Stereo ma I can pronounce that correctly now. These are considered by many to be military terms right military terms Taxis referring to good order or a lining up of soldiers in a battle ray, right? If you can imagine Roman guard for example, and they're all lined up in their armor Lined up with their weapons. They're in good military order and then Stereo Oma meaning a steadfast or firm Referring to the strength of that order. I lined up in battle array shields out swords drawn There's a firmness or a stability to those battle formations The church at Coloss is in good disciplined military order And that order is firm and secure and that is something that Paul is rejoicing in Working order defenses are well established well in place and it suggests that the Colossians are running a tight ship They're running a tight ship a disciplined ship And therefore running a tight ship running a discipline ship the church at Coloss is well prepared to defend themselves against attack in particular in context it's Attack or the threat from false teaching false teachers But we could conceive of many ways in which the church is under attack. Couldn't we that good order? Would serve us well to defend ourselves against that attack, right? So good order a steadfastness of firmness in our faith and good order will defend us Against threats against trouble against attack. It's the same word. Toxas. It's the same word used in 1st Corinthians chapter 14 verse 40 Paul says in verse 33 God is not the author of confusion, but of peace as in all the churches of the saints and in verse 40 Paul says let all things be done then decently and in order same word In Titus chapter 1 verse 5 turn over to Titus chapter 1 verse 5 with me And we're talking about the basis for the general use of a constitution in the church and the first Basis for the general use of a church constitution is necessary church order in chapter 1 Titus chapter 1 Beginning in verse 4 to Titus a true son in our common faith Grace mercy and peace from God the father and the Lord Jesus Christ our savior He tells Titus for this reason I left you in Crete that you should set in order the things that are lacking Set in order the things that are lacking at a point elders in every city as I commanded you the word Order there is epi Dior thought oh epi Dior thought oh it's Referring to Something that's not in complete order something that needs additional order right Paul is leaving Titus in Crete so that Titus can further order those things in the churches of Crete right he can set things in order He can further organize that which is lacking the things that are lacking are plural and Then Paul gives a representative example. He is to appoint elders in every city So I think from them the indication by the plural right the things plural that are lacking That in the churches of Crete there were several things that were lacking in any church There may be several things that are lacking but chief among those would be elders that needed to be appointed in every city So of the things that are lacking in a church leadership is of primary importance It is of primary importance that Titus appoint elders and then elders can help with Putting things or setting things in order those things which are lacking Okay, but the point of this all is that with respect to a church there is to be order in the church There are those things which are lacking that pertain to order that pertain to governance that pertain to polity Pertain to how we live and conduct ourselves in the household of God and these things are to be put in order in everything Paul says let everything be done Decently and in order and with that church in Coloss Paul is impressed. He's rejoicing in their good order, right? So the basis that the basis of its general use Why would we have a constitution is to facilitate good order? Okay, any questions about that so far? All right, so a constitution helps us to facilitate good order second on your notes there in the outline that order Good church order is a a responsibility of autonomy It's a responsibility of autonomy and what do we mean by that? Baptist churches all churches are supposed to be Baptist churches are autonomous it comes from one word auto nammas auto meaning self Not a namas meaning law in other words autonomous means self governing or self Directing self Regulating churches. They are self governing self regulating under the lordship of Jesus Christ But each local church is responsible for its own order so Order in the church is a function of our autonomy. We don't go to a denomination For order. We don't submit ourselves to a hierarchy for order. We don't go to Cardinals and bishops and popes We don't go to a magisterium We are responsible for our own order. You see that throughout the New Testament, right? It's amazing to me that we sometimes lose sight of the fact that the letters of the New Testament were written to individual churches to communities a scattered across Asia in The first century and these were local churches that were responsible for their own order autonomy Means that the church solely under the lordship of Jesus Christ and the guidance of the Holy Spirit Selects its pastoral Leadership appoints deacons Determines its worship decides financial matters admits members Exercises discipline and directs other church related affairs without Outside control or supervision other than the supervision of the Lord Jesus Christ himself who is the head of the church, right? So autonomy means that the church is responsible for all those things, okay? So being autonomous then Point to there being autonomous a church recognizes no Modern mental control over faith and religious practice A church is to establish its own governmental control Although churches obey the laws of governments related to certain matters They refuse to recognize the authority of governments in matters of doctrine and matters of polity and ministry And Matthew chapter 22 verse 21 The Lord says a render to Caesar that which is Caesar and to God those things which are God's right And that's a principle that applies certainly in that specific context that takes place there in Matthew chapter 22 But also applies in a broad array of context with respect to the church the church is not Submitted in that sense to Caesar We're not submitted to governments. We are autonomous now Baptists Have From their inception really have upheld a separation of church and state We're gonna talk about that more as we work through this series on the church Baptists have consistently rejected the efforts of secular governments or a government entity to dictate to a church What to believe how to practice how to worship how? We should appoint elders or members who should or should not be members That is at the discretion of each individual church because each interval individual church is autonomous, right? And we don't submit ourselves in that sense to para church organizations like denominations like Associations of churches that then begin to lord it over the members of their association or The extra structures extra biblical structures that are imposed upon the church. We see No examples of that in the New Testament. It simply doesn't exist and we think about we will talk about this more in the future But when we speak about then the regulative principle whatever we don't see commanded or Commended in the Bible is expressly forbidden in our worship or in our doctrine in our practice, right? So we look to God's word then for warrant as to how we are to function is how we are to operate And we don't see those extra biblical para church hierarchical organizations or structures in the Bible each church is on an autonomous body Churches as our confession says churches may relate to one another and they do start they do so in terms of fellowship Our confession refers to it as holding communion together Right in that holding communion together that communion the communion of saints We're gonna talk about that tonight the communion of saints the fellowship of the saints we see in the cause of the gospel We see in matters that exist between churches like members transferring back and forth or people moving back and forth But no individual group Organization Exercises authority over the church that church alone is responsible for its own government and order That's a principle of Sola script here up Right the Bible alone is our supreme authority in all matters pertaining to faith and practice and the regulative principle then applies The New Testament recognizes no para church no hierarchical governmental structure Therefore autonomous churches are responsible for church order including governance, okay, so Point one then on your notes. We were discussing the basis for the general use of a constitution Why would we have a church constitution? Someone might say right you hear people will say sometimes No creeds, but Christ no books, but the Bible and we shouldn't have anything that exists outside the Bible We need help with sometimes systematizing what the Bible teaches the Bible is full huge rich deep Document and sometimes with respect. What does the Bible teach about appointing elders? We need to systemize all that the Bible teaches about appointing elders and then it's good to write that down So we know what the Bible teaches about appointing elders And so that we have a basis or a framework on what on which we can agree on what the Bible teaches about appointing elders So that you know Frank or Sally or Tom who come into the church can say well I think the Bible says this about no, no, no This is what we as a church believe the Bible teaches clearly about appointing elders and all that should come from scripture But it helps us to systemize systematize that good teaching. Okay Point one the basis for its general use one necessary church order and that order is a necessary function of our Autonomy as a biblical church any questions about point one then on your notes The basis for its general use This is why we have a constitution Okay, moving on to point two good Let's talk about next then Reasons for its specific form all right reasons for its specific form Why do we have it in the form of a church? Constitution why is it arranged the way that it is why do we use this document in the way that we use it? There are practical reasons and then there are legal reasons right practical reasons and legal reasons Let's first discuss the practical reasons together. Okay? first of the practical reasons there are reasons that are For the help the benefit the blessing of the individual or London Baptist Confession of Faith of 1689 in chapter 26 on the church Article 12 if you've got your church app you can punch that in and be there in two seconds Under article 12 our confession says that as all believers are bound to join themselves to particular churches When and where they have opportunity so to do so all that are admitted under the privileges of a church are also under the censures and Government there of according to the rule of Christ. Okay, so now that's um Bit of a loaded statement But it's a really good really helpful statement with respect to your membership in Local church, but in particular in our church. Okay, what is what is our confession saying there chapter 26 article 12 first? All believers are bound to join themselves to particular churches Means that believers are to commit themselves We would say through baptism and through membership are to commit to themselves to serve in particular local churches In obedience to the command of Jesus Christ, right? It's it's um not biblical for people to float from church to church or to Sit sort of on the outskirts if you will uncommitted Uninvolved unengaged in a church believers are bound to join themselves to the church That's point number one that the confession makes and that's by the command of Jesus Christ When and where they have opportunity so to do So that's why we would say to regular attenders here, right? Once you visit our church We want visitors to feel welcome. We want visitors to come we want guests to be able to stay with us Why because we want them to get to know us? We want them to understand who we are what we believe why we believe it what we do and why we do it We're very intentional about the things that we do here very specific about what we do here and that's for a very good reason and so anyone that comes we want to give them time to Get to know that and to get to understand that by the same token. We want to get to know them Don't we all right? We have a responsibility With who comes into the membership of the local church. We'll talk about it a minute why that's important and The the things that we should consider in admitting members to the church But for that member it's really important to understand what they're getting themselves into They are bound to join themselves and when they join I say this on a regular basis to new members We're not joining you. You're joining us, okay? You're joining us. We're not joining you That's a good perspective to keep in mind You need to understand what you're getting yourself into okay So that they're they're bound to join themselves to particular churches so that They are admitted unto the privileges of the church When they join themselves at the church, they're admitted to the privileges of the church. Well, what are those privileges? All right, what are what are those privileges now? I can as I say that statement I can just things pop into my head, you know pop into my head all the blessings and privileges of the church But many times the blessings and privileges of membership in a church go beyond those things that might Immediately pop into your head that are oftentimes associated with the blessings of just being a christian right the blessings of fellowship The blessings of communion with the saints But you also have privileges of membership that that regular attenders or guests do not enjoy Where are those benefits or privileges? Where are they? Outlined where they listed In our constitution right in our constitution You have benefits of being a member of a local church, but you also have responsibilities of membership. Where are those responsibilities? Listed they're listed in our constitution our constitution is not an exhaustive or a comprehensive list of those blessings and responsibilities But it is a representative list And a very important list if you're going to exercise Responsibilities of membership among us. Okay, you're going to find those in the constitution Also, though when you bind yourselves to a particular church You're submitting yourselves to the censures of the church. This is extremely important, right? Our confession they are also under the censures and the government thereof So by becoming a member of the church you submit yourself willingly voluntarily under the censures or the discipline And of under the governance of this church Now obviously the censures or the discipline of this church is explained in the bible The government of this church is explained in the bible But what our constitution enables us to do is to systematize all of that teaching Right the various texts related to discipline, right? Matthew chapter 18 first Corinthians chapter 5 second pestilence chapter 3 Titus chapter 3 right several texts that deal with discipline How we're how are we to understand those texts? How do we apply those texts in practice? It's laid out in our constitution It's laid out in the documents of our governance those documents of good order When we think about censure when we think about government when we think about discipline when we think about rights and responsibilities of membership We outline those in a systematic way in our constitution So that we can easily see and refer to those In matters of practice, okay? So you're submitting yourself under the censures of the church You're submitting yourself under the government of the church and that lastly in our confession That's according to the rule of christ According to the rule of christ points us back to the bible Uh and points us back to the regulative principle or solar scriptura That how we govern ourselves how we conduct ourselves Should be according to the bible whatever is commanded or commended That is what we want to do that which is not commanded or commended is forbidden in our practice or in our worship, okay? So those are practical reasons to the individual What about practical reasons for our body as a local church corporate? Reasons not just individual reasons, but corporate reasons Well, um our constitution then becomes a means By which we endeavor to maintain the unity of the spirit in the bond of peace um Years ago many of you you old timers here We got many of them in the room Older we got many new timers in the room too, but uh you old timers will remember Back when uh, you know, we're going through a period of difficulty or a period of trial in our church How everything began to be questioned, right? Everything was held up to a scrutiny and there is a sense in which that is Good, right? Everything is held up to scrutiny everything is Should be questioned and it should be questioned according to scripture a lot of times when you get these bodies like um Many churches for example Where just over a period of time things devolve in a little more than just base traditionalism You end up following the commandments of men teaching those commandments of men as doctrines of god And you wind up in all kinds of of error and trouble so we don't want to Give ourselves over to just base Traditionalism everything's up for scrutiny and should be scrutinized under the word of god And so if anybody if the if if someone Fresh out of the oven they've been converted three minutes They walk up to me and say you guys are doing this, but this is what it says in the bible and they're right What are we gonna do that minute? I'm I'm committed. I'm we're we're a pledge to one another that that minute that thing is changing Right because that's what the bible teaches and we need to be obeying the bible and not the traditions of men and so That is always up for scrutiny. However We are very intentional here And we we try to be lord help us try to be as thoughtful as we can about what we do and why we do it And so many of those things given time have been um Considered under the searing spotlight of god's word and we have carefully and I believe With a clear conscience before god faithfully Set those practices in place in a way that we believe honors the lord and Steams the lord's church and so that systematizing then of those Questions and issues of doctrine and practice that we've tried to be careful about working through Our systematizing of those things then becomes a means by which we protect or endeavor labor To maintain our unity the unity of the spirit in the bond of peace Such that uh during those times of volatility like we went through in the past when somebody comes up and says Why are we following this 1689 thing? There are too many things here that we would disagree with and I like Who's the weed? Do you have a mouse in your pocket? No, no, no, we we believe we hold to the 1689 London Baptist Convention. That's not something we're going to change. Why do we Do expository preaching? Why would we we should be a topical? No We we have determined that expository preaching is what we're going to be fundamentally about and here's why we have Agreed together to be committed to that Form of preaching and teaching and in the Lord's church, right? These fundamental things What a document? like a Constitution a confession or a covenant what those documents do Is uh protect ourselves corporately From what can be the shifting sands of man's preferences and opinions given time, right? It should be really Difficult and it is to change your constitution or to change your confession or to change your covenant Right at the time when all that volatility was taking place people rightly Began to think to themselves is our covenant Something that still stands Or is it something we need to completely scrap and do over right and after Length these things don't happen in a moment either, right? If somebody comes up to you and says Listen, we need to amend our constitution and we need to do it by tuesday That is ample reason in and of itself not to do it by tuesday, right? We're we we need to take our time and needs to take a long period of time and it did right we we Um You know for example that that real difficulty the trials in our church at that time that was you know 2012 It seems like a lifetime ago and 2012 seems so recent It seems like a lifetime ago, but we we ended up over a period of a couple of years thinking through all those issues and Rerote our constitution in 2014 To reflect those things that we had learned, but it was two years of dealing with those things and thinking through those things And two years is a very short amount of time, right? We should this this our constitution should be more ensconced if you will over years and years of use And it should be difficult to amend So it it it becomes then a means the word of god is what stands behind the constitution The word of god is what the constitution reflects the word of god is timeless And so our constitution then becomes a means by which The lord through his word protects Our unity and our peace around those things we've determined are important to church governance church polity Our faith and practice okay any any questions or thoughts about that? Really important for that reason Secondly with regard to corporate reasons or corporate benefits to a constitution It's a means of our protection The lord we do not put our faith or trust in chariots or horses Our trust is in the living god Uh, but our god uses means And we are to be wise and we are to be prudent and our constitution is a means through which god May protect our church and when I use that word may uh on purpose Um, and we'll talk about that in just a moment. Um, so We've talked about the reasons for its specific form There are practical reasons. Secondly, there are practical reasons including both individual reasons and corporate reasons Secondly, there are legal reasons. We need to move along here Actually get to talk about the constitution itself legal reasons We talked about church autonomy Right, there is a relationship between that autonomy and the state So when we get into our series on the church and we're going to talk about the church and the state and we're going to talk about um Something i've been reading about lately called sphere sovereignty sphere sovereignty. Let me give you an example briefly God has created institutions One of the institutions that god has created is the church Another institution that god has created is the family another institution that god has created is government, right? government governments are instituted by god roman chapter 13, right? So governments are instituted by god in each of those spheres There is responsibility There is sovereignty Over responsibilities. There is a stewardship given to each of those spheres of authority, right? abraham kuiper, uh, dutch reformer, uh, dutch theologian referred to that as sphere sovereignty and what happens often often Is one of those spheres will um Grasp for itself more sovereignty Then it is strictly and biblically entitled to and like The river jordan it will overflow its banks Into other spheres now in history. We've seen that happen frequently with a church, haven't we? Where the church begins to act like the state and the church begins to imprison people and It's it's um An unbiblical extension of israel's theocracy into the new covenant church where it doesn't belong and the church begins to um grasp for itself um A sovereignty if you will that doesn't properly belong to it. Jesus christ says my kingdom is not of this world Okay, we'll talk about that when we get there um What we see in our day and what we've seen most frequently throughout history Is the government overspilling its banks into a sphere where it does not belong And that's what we see principally right now. Uh, I think the um those who uh Wrote our constitution our united states constitution Would be sickened and disgusted by the encroachment of our government into the sphere Sovereignty of the church and that's why it's so important that we begin to talk about that as a church here very soon. So, um But there is this the relationship between church and state And that relationship has been defined in terms of something called the church autonomy doctrine The church autonomy doctrine or ecclesiastical extension or ecclesiastical abstention what that um Does what the church autonomy doctrine we're talking about legal terms now is it establishes a constitutional denial of Jurisdiction in other words the state The government has no jurisdiction in ecclesiastical matters Um The the church autonomy doctrine by definition establishes a constitutional denial of jurisdiction Grounded in the free exercise clause of the first amendment right the free exercise of religion clause in the first amendment Rational for this is that courts do not have the competence or the capacity to decide questions of doctrine religious doctrine And civil courts must not make what amounts to religious pronouncements And we see the court attempting to do that on a regular basis, but courts aren't equipped aren't capable of doing that They have no competence to do that our constitution prevents them from doing that restricts them from doing that And the bible says they shouldn't be doing that. Okay Now this has been upheld in the history of our country Over decades and decades in particularly in uh 2002 case law mckelvey versus pierce Listen to some of the things that the court decided this is continuously upheld this court um agreed upon Ecclesiastical jurisdiction listen to what um is said in this decision The doctrine this doctrine church autonomy doctrine is rooted both in both of the religious Clauses of our constitution Protecting a church's freedom to regulate its own internal affairs by prohibiting civil court review of internal church Disputes involving matters of faith doctrine church governance and polity It puts a distinction between the two the essence of church autonomy Is that the church should be run by duly constituted church authorities? and not by legislators administrative agencies labor unions disgruntled laypeople or other actors lacking authority under church law right Church autonomy is also rooted in case law That affirms the fundamental right of churches to decide for themselves Free from state interference matters of church government as well as those of faith and of doctrine Um, in other words, there is this ecclesiastical jurisdiction that is recognized between the sphere sovereignty of the state And that of the church and it's important that we maintain the distinction of the difference between those two now um One of the reasons that we say there is a legal reason for having a church constitution is that um it's not It doesn't function well to go into The courts of the state with your bible And say this is what the bible says. So this is what we're going to do The bible is interpreted and the state understands it interpreted by the various autonomous churches That exist And those churches have their own um understanding their own A codification if you will of church polity Where is that church polity to be expressed or codified? It's expressed or codified in our constitution and the state those court Jurisdictions of the state recognize or acknowledge church constitutions. So we put our constitution together one of the The reasons that we put our constitution together is for the benefit for the blessing of the people coming to our church for you So that you understand so that we understand together what we're all about and why we are all about it But then secondly, it's to help us in our relationship with the state or with the courts And in that sense it becomes a document that protects us also, right? There are many things that in That are connected to this many reasons why that's important. Okay That ecclesiastical protection that comes from Our use of a document like a church constitution Um Comes through or arises from membership Now when somebody's here for a period of time It is assumed that those who are here for a period of time are submitting themselves to our practice here, right? So it's um, there's a common law if you will if you're here for a period of time It's acknowledged and he'll holds up in court on a regular basis That you're submitting yourselves to the way that we do things here and you're doing that By coming by attending But this ecclesiastical protection from our church really arises from membership. It's the people of god here coming together in our Joint membership and saying these are the things that we believe Here's how we are going to function. This is what we believe that our government should be about Here's how we are to practice the things that we believe and we're saying as a church body This is what it is and we've systematized that in this document called a church constitution So that when that or if that is challenged Um, we can say no no. Here's where where it is and here's what we believe And that's why if you read our constitution also you'll see a lot of scripture referenced in our constitution Scripture is referenced throughout. It's not You know some constitutions you'll see is sort of like these boilerplate boilerplate documents that have nothing in them But a couple of um statements We loaded ours with scripture. Why? Because it establishes jurisdiction The state has no jurisdiction the bible has jurisdiction questions. Yeah any questions Yes Kind of a side note from what we're talking about if someone's been coming here for like two years But they're not an official member haven't signed the covenant. Can they still be put under church discipline? Yeah, that's a very good question and where would you find One place where would you find the answer to that question? In our church constitution. Yes, it's a good question brother and yes Like that's a really important question right church discipline Is to be practiced on members of the church So we would not practice church discipline on a non-member somebody From a biblical or constitutional basis. Um, somebody explained to me why that is why would we not practice discipline On a non-member Someone who's not a member of our church Anybody nope, nancy. I want to take a stab at it Yeah Well, they may not be believers because when people are become members of the church They're members. I mean they're they're they're believers. We're affirming their profession, right? Yeah, so that's a maybe a portion of it Yes, very good very good Yeah one for right when somebody joins our church. We're affirming them. We're affirming their profession of faith. So josh Oh I was gonna say that they haven't officially given consent To uh to that as of yet. Yeah, you're getting there right? Yes. So they're they're they have not Voluntarily yet have not voluntarily submitted themselves To the as our confession of faith states it the censures and the government of our church, right josh In uh first corinthians chapter 5 Verse 12 It says For what have I to do with judging those also who are outside? Do not judge those who are inside So there's a clear distinction between those who are Inside the church and those who are outside. Yeah amen and how are we to? Um Determine or to delineate Distinguish those who are on the outside from those who are on the inside one of the ways that we do that is through church membership Yeah, very good. Very good question. Yes, sir brother Morning brother. Good morning If someone has been attending our church and has made a profession of faith for two years But is living in a practice of sin. We will deal with them Yes, and yeah, thank you brother for bringing up that distinction So there is in this our Are our constitution also discusses this there is a distinction between what we would consider to be formative church discipline And corrective church discipline, right? So Anyone who comes to our church like according to matthew 18 according to first corinthians chapter 5 Anyone who would come to our church we would approach them in sin And deal with them according to the bible, right? But in terms of x communication in terms of Saying we no longer affirm your profession of faith As a believer we reserve that corrective church discipline only for members of the church What we would do in the case of someone here who was In unrepentant sin that way if that rose to the degree that we are Working through matthew 18 for example with them and we reached that point of telling it to the church We're going to ask them to leave Um In a sense you can stay here, but you can't cause trouble All right, so we're going to ask you to leave the church But the censures of the church or the did the corrective discipline of the church is reserved for those who are Members of the church those who have voluntarily submitted themselves to the censures and government of our church Um, so in that sense x communication the practice of the church For its members Last question josh Oh just another comment if someone's been here for like maybe one year or Even a little bit more than that we would ask them. Why haven't they become members yet? Yes, yeah, so they're and if they don't want to become members of the church We would ask them to seek membership elsewhere. Yeah, very good. So even before You know it it does happen, you know where there's church discipline. We have to deal with sin when it comes Oh, I don't think that was my voice um But um If they've been here for a good amount of time, we would encourage them to become members Yeah, very good. Yeah our confession, right? Um, they are bound To join themselves to a local church By the command of christ So yeah, if if we will tell folks um, and we have and uh, if you can't join here Then go somewhere where you can join you need to be a member of a church And part of that is the accountability that comes with Um church governance church polity polity in particular, um discipline Last minute here, and then we're gonna have to close out to get ready for the morning service Um, you've got your copy of the constitution. We've talked about I think those two things are important We don't usually get an opportunity to talk about the basis for the general use of a constitution And then the reasons for a specific form in particular those Individual corporate and legal reasons So I wanted to go over those with you, but you have a hard copy of our constitution We've got more available at the welcome desk if you'd like to have one you've got it on the church app I want to invite you uh, take some time maybe in Fellowship take some time with your family just read through these various sections I think they're very important article six on church membership the qualifications for church membership Uh admission to church membership responsibilities, um article e A responsibilities and privileges of church membership Uh termination of church membership Um article seven an entire article dedicated to church discipline how we view church discipline How we practice church discipline very very important and this is you know, we go through this with new members because this is um What you as a member of our church are submitting yourself to in the practice of the church Now we believe that this accurately and faithfully represents what the bible teaches Uh and how we are to practice, but this flesh is out Gives practicality to what we believe the bible teaches. So really really important. Um, the things that you're responsible for voting for we're we're um considered uh an elder led Governance an elder led polity But we for the sake of unity and for the sake of our peace involve the congregation on many many decisions and votes And so you have a responsibility uh to vote on in many many cases Admitting members we involve the congregation in cases of church discipline We involve the congregation in appointing elders and deacons. We involve the church In amending this constitution requires a three fourths vote of our membership to amend the constitution To buy property would require a vote of our congregation, right? So many things in which um many ways in which although we are Elder led because we believe that's what the bible teaches In many cases. We are congregational in terms of the decisions that we're we're going to be going to be making because we involve The congregation in that okay That suffices for our very Top level overview of the church constitution. We'll look at the covenant next week if you have questions Please feel free to come and ask. We'll be happy to discuss that with you. Let's pray Father in heaven lord, thank you for your word. Thank you for the basis that your word gives us a good sure guide your truth that Gives us all the instruction that we need to govern ourselves properly. Thank you for The commendation of Paul and others to good order in the church and help us lord to be faithful To establish maintain sustain and practice good order doing everything here decently in an order For your glory and for our own blessing and benefit for our own protection Help us to Faithfully adhere to what the word of god clearly teaches on these things help us to Maintain endeavor labor to maintain the unity of the spirit in the bond of peace Through the use of these means like a church Constitution and although lord, we understand that you are the one who protects us. We pray lord that you would Help us to operate in wisdom By implementing a document like this to protect us from Those that would seek to undermine the church or do us harm I pray lord that we would look to you For that protection trust you for it and lord, please protect us We love you and depend upon you for all these things in jesus name. Amen