Mr. Paul Hoeber was also present in person, representing his company with a large number of standard works. To him we owe, among other things, the popularization in America of Emery's Immunity.

The Institute meeting itself was marked by absence of any acrimonious spirit. Even the warm rivalry for presidential honors was not in any way marred by unfriendly competition.

The session began on Sunday with exercises in memory of the year's dead. These were made very impressive by the beautiful solos of Miss Isabel Stevens of Boston, an interesting and interested visitor during the entire week.

On Monday morning the business sessions were formally opened and nominations for officers for the coming year were made. Tuesday was the day of election. This resulted, as announced in the Gazette last month, in the accession to the presidency of Dr. Thomas H. Carmicheal of Philadelphia. The ballot for first vice-president ended in no election, but by a later vote Dr. William H. Dieffenbach of New York as elected. Dr. Clara E. Gary of Boston was second vice-president, Dr. J. Richey Horner of Cleveland re-elected secretary and Dr. T. Franklin Smith of New York treasurer.

On Wednesday Dr. James Ward presented the report of the Committee on Legislation. This evoked much discussion and will be heard from later. At the other business sessions it was decided to continue the position of field-secretary which Dr. Arndt has so ably filled during the past year. A subscription from the floor was started that in a few minutes reached nearly three thousand dollars. At the final session Pittsburg was announced as the place of the next meeting.

The scientific sessions were by no means behind the business ones in point of interest and were well attended throughout. It is scarcely possible to single out any special ones, although from the standpoint of purely original work those of Bailey of Chicago and Dieffenbach of New York, together with the report of typhoidtherapy from Boston, gave perhaps the most evidence of actual research. Drs. Southwick and A. G. Howard of Boston each gave papers which drew large audiences.

Ogden of St. Paul started a warm discussion concerning puerperal sepsis which proved instructive. The paper of Duncan of New York came at an unfortunate time and did not have the audience it deserved in order to bring out the pros and cons of his peculiar methods of treatment. We have heard from time to time the statement that the Institute meetings do not bring forth anything of value to the auditors, but merely a rehash of what has already been heard time after time. The best refutation of such a statement is the record of the scientific session of the meeting just concluded. If any attendant went away from it without receiving some new ideas and new interests, all we can say is that it was his own fault, not that of the Institute.

The social features were well arranged, with a ball on Mon

day evening, an enjoyable trip to Newport by steamer, with a carriage drive about the city on Tuesday, a boat ride and clam bake at Rocky Point on Thursday and a banquet on Friday evening. When we say that at the banquet, our own Dr. Wilcox was toastmaster, nothing further need be said about the humor and merriment of the hour. In addition the ladies of the Meissen enjoyed a daily afternoon tea, automobile excursions and an afternoon bridge party. At the musicale on Wednesday evening Dr. and Mrs. George B. Rice easily carried off the honors among an excellent representation of Boston musical talent.

This wandering account would be incomplete without mention. of the excellent press work of Dr. G. F. Martin and of the unusual prominence given to the daily sessions by his brother, who is editor of the Providence Journal to whom the thanks of the Institute are certainly due.

And so the Institute meeting at Narragansett Pier has passed into history where it will be recorded as one successful in all respects, reflecting much credit upon both hosts and guests.

Hail Pittsburg and 1912 (also Miller, Portland, Ore., and 1915)!

Antivivisection.-A certain Capt. C. L. Perkins of the British Royal Navy has recently become a sponsor for a peculiar appeal to sentiment that has been widely circulated in England. It consists of the following: "O God of mercy, send kind death to thy dear dumb creatures, left tortured and agonizing in the laboratories, when the vivisectors go home to dine and sleep." An attempt was made to have certain New England clergymen offer this prayer and from one of such the following answer was received as it appeared in the Boston Herald: "What a delicious paradox this is. Here is a man whose only business is, in time of war, to maim and slaughter his fellowmen, praying every night against those whose profession is to save human life. I think I see him at one moment urging his gunners to rake the enemy's decks fore and aft, yelling like an Ashanti, 'Give 'em h-1, boys,' and several hours later, kneeling in pink pajamas before his berth, slobbering a few maudlin tears over the cats and dogs and rabbits which he thinks the vivisectors have left in their misery. You have asked me, Captain Perkins, to adopt your daily petition as my own. I am almost willing to say yes, but on one condition. Will you offer a prayer of mine, not every day, but once in a while, at least? This is the prayer which I wish you, Captain, and all others of your rank might offer: O God of nations, send kind death to thy poor soldiers and sailors left mangled and moaning after the battle, while the captains and the kings sit down to celebrate their victory in wine and song. Remember, we beseech Thee, the widows and little children made desolate by brutal conflicts of greed and plunder, brought on too often by an insensate thirst for glory and reward. Save us, our Father, from all who in their blindness foment jealousy between nations and hatred among races, and most of all from those who for the sake of gold would plunge their country into the hellishness of war.' But perhaps I have taken the captain and his prayer too seriously. The card is doubtless a new device in pamphleteering, and a rather clever one, were it not for the stupid blunder of giving the occupation of the writer. I cannot offer such a prayer as this. I know too well the blessings that vivisection has brought to mankind. For my part, I prefer to offer a prayer which will include both sides: for the vivisectors, that they may ever be kept from causing unnecessary pain; for the antivivisectionists, that they may be given that due sense of proportion which will turn them from misdirected sentiment and set their moral enthusiasm free for attacking the really great and sinister evils that beset society."

THE ADVANTAGES OF SMALLER MEDICAL SCHOOLS.

In the annual presentation of statistics of the State Board results for 1910, the Journal of the American Medical Association makes the following comment upon relative value of the small and the large medical college:

Table E is also based on the three large tables and gives the results of state board examinations as they affect the 42 largest medical colleges. Although these colleges represent less than one-third of the medical colleges in the United States, they furnish nearly two-thirds of all the candidates for license. This table shows that the graduation of large classes by a medical college does not prove excellence of teaching, since several colleges having 100 or more examined have very high failure percentages, and this holds true even for the graduates of 1910. In fact, the larger the college from the standpoint of the number of students and graduates the more serious is inferior teaching ability, indicated by a high failure percentage. In fairness to the medical student, and in the interests of the public, such schools should greatly strengthen their teaching facilities or reduce the size of their classes.

THE AIM OF THE MODERN HOSPITAL.

A number of inquiries have reached the editors concerning the reasons for present day medical research and some of the problems that are to be attempted. In answer to such inquiry an admirable editorial that recently appeared in the Cleveland Medical Journal, entitled, "The Aim of the Modern Hospital,” is quoted in its entirety.

"The nineteenth century brought with it an entire revolution in medical thought. The discoveries of Lister and Pasteur, and the investigations which followed, opened up an entirely new field for advance, and led directly to the development of modern surgery. The multifarious observations on methods of combatting bacterial infections had two great and fundamental results, the one centered the thoughts of workers on the perfecting of aseptic surgery, the other pointed out the need for hospitals where such surgery could be practised after the most approved methods. The days of hospital gangrene, of puerperal septicemia, of general putrescence, whenever wounds or openings in the body covering occurred, passed slowly away, and became historic horrors along with the sufferings of those who had to be manipulated for this or that without the saving oblivion of anesthesia.

"The effect of this new knowledge on hospital architecture and hospital management was profound. Light, air and cleanliness came where darkness, stench and filth had been. Operating rooms, sterilizing rooms, places for dealing with "clean" and "dirty" cases followed one after the other. As surgery advanced the hospitals where good surgery was done advanced also, until the surgical wards of most of the large hospitals in this country were models of method, cleanliness and organization. The tremendous interest in surgery, the great increase in the number of surgical patients, made the surgical divisions by far the most alluring and important part of our general hospitals. During this period of surgical advance, the medical wards did not increase in size nor in activity. Occasional new diagnostic methods were practised, more and more the wards were used for the intimate teaching of the students, but on the whole the medical wards in most hospitals have been a necessary, though slow going, adjunct. To be a "great surgical hospital" has been the proudest boast of most of our great institutions.

The pendulum has swung as far as it can, and is swinging back. Re cently great advances have been made along the lines of internal medicine, in the more careful analysis of the deeply underlying problems of disease. The last ten years have shown a great increase in the knowledge of abnor nial metabolic processes and of the abnormal physiology associated with

pathological conditions. New methods for the study of disease have arisen. Biochemistry, physical chemisty and physiology are becoming more needed day by day in the elucidation of the broader problems of modern pathology. New methods of treatment have arisen, based on this new knowledge. Up to the present the bulk of this work has been done in laboratories at a distance from the hospital, or patients have been transported to the laboratories for study and returned again to the clinic, a tedious and cumbersome procedure. It is becoming evident that a hospital to be in the advance guard of medical progress, cannot be satisfied with an active surgical service, and a medical division of the "purge-and-puke," "pill-andpowder" vintage. It must have in connection with its medical wards laboratories where the most advanced methods of clinical investigation may be carried out, not tucked away in some out of the way corner of the hospital, but within easy reach of the wards. The medical wards should have a complete laboratory for chemical, bacteriological and physiological observation, just as much as the surgical wards should have their operating suites. In no other way can real clinical observation be carried on to-day. The days of the tabulation of symptoms and signs, as judged only by the eyes, ears and fingers of the observer, have served their day and passed. Clinical observation means all this in conjunction with the more minute study which the great advances in pathological physiology have made possible. To those who believe that all this is as necessary a part of a hospital today, as was a sterilizing plant and an operating room 20 years ago, such an arrangement seems possible, and greatly to be desired; to those who still believe that all the facts necessary for the advancement of cur knowledge of disease can be gleaned by the eyes, ears, fingers and the microscope, this cry for more complete equipment and larger scope of work is hailed as the ranting of the unsound. Such men, and their name is legion, hold the same position now that the scoffers at the "germ theory" held 30 or 40 years ago.

In the fall of 1910, the Rockefeller Hospital was opened in New York, for the study of disease. Perfect from the point of view of modern hospital construction; supplied with laboratories and appliances so that the searchlights of modern knowledge may be focused on the obscure problems under consideration; manned by a keen staff of men trained in modern clinical medicine, quite as at home by the bedside as in the laboratory, able to do everything for the patient from the physical examination to the most complex laboratory investigations, it stands as the greatest institution for clinical research in this country. The staff is sufficient, so that no man need be rushed and crowded by a senseless mass of routine. The patient is studied, the condition elucidated and the treatment planned with equal care and attention to detail. The eyes of the thinking medical world of this country are turned toward this new hospital, with hope and with expectation. It is a great move in the right direction, and as such should be greeted as pioneer and guide. The day will come when each hospital will have facilities for such clinical study of cases, will have its staff of well trained and brilliant young minds, working under the leadership of some worker of mature judgment and great experience. The united efforts of such a combination of facilities and individuals will produce work of untold value to the patients, the community and to the profession. To the community which makes the beginnings of such work, will come the award of gratitude of future generations of physicians and of laymen in this great land of ours.

WHO HAS THE BABY?

R. D.

The following is copied from the Medical Brief, which in turn, as will be seen, abstracted it from The Mirror. While we by no means agree with all the sentiments herein expressed, it emphasizes a condition in the natural sequence of events that is sometimes overlooked.

A doctor's wife, in a communication to The Mirror, puts in a strong and timely word for the part which "mere man" plays in the birth of the baby. Referring to an editorial in The Mirror in which Dr. Eliot was taken

to task for his "baby every two years" advice, on the ground that Dr. Eliot is a man, and men don't have to "have babies," this correspondent says: "That was a great stroke, your comment on President Eliot's idea of a baby every two years for women. Your women readers all settled back most complacently, self-satisfied, I know, on reading it, but the men do have the babies.

"From the very beginning of the order for a baby the husband's martyrdom begins. He must never lose his temper. He must be all gentleness, all patience. Wife must not be worried while she is busy with her baby. It may be her soul is no larger than a pin-head, she may be a naturally born nagger, yet she is not expected to try to overcome it. She is allowed to revel in all her petty tempers and meannesses. The hired girls may leave, the rest of the family retire to solitude, but father must stand by, for isn't he the cause of it all?

"Who is it has nervous prostration, all by himself with no coddling, when the baby comes? Father. It isn't all a joke, the little facetious local notice, 'Father is doing well.' In the ladies' magazines, father is out on the lawn smoking like a burnt-out bonfire, or pacing the gallery, only stopping to inquire if all is well, but in real life father is on the spot, helping the doctor, cussing the nurse and encouraging and soothing the wife. In a few days, wife and baby, beruffled, beribboned and sacheted, are blissfully receiving admiring relatives and friends; nothing to do but just be congratulated on the wonder of wonders. Father gets some good-natured chaffing and cuts an extra hole in his galluses, hitches up a little tighter and goes on 'having the baby' until she is grown, educated and married or unti! son has been saved from the penitentiary a time or two and is finally landed at some business that will pay his board and clothe him. No one ever hears of father reneging on the number of babies. Each new one is the finest yet. Let someone design a maternity medal for dear old dad.

"P. S. Being a doctor's wife, I couldn't write this without the obstetrics, but you will get my meaning. I know."

THE PAINLESSNESS OF DEATH.

The final passage of that which is variously denominated the soul, the personality or the ego from the present realm to a future one is a matter that sooner or later comes to all. Anything that tends to mitigate the fear which some individuals may have of this passage from the strictly physical side may be of interest. In a recent number of the Dietetic and Hygienic Gazette, quotation is made from a paper by Oldfield that appeared in the Herald of the Golden Age:

"Bacon puts it this way: 'It is as natural to die as to be born, and to a little child the one is as painful as the other.' By this I think he means that it is no more painful,' and with this view of natural birth and death I wholly agree. So little does the apparently painful process of being born affect us that it does not ever leave the faintest trace upon our memory.

"The apparent painfulness of a natural death is equally illusory, and I believe that we shall awake in equal forgetfulness of the sensation of dying. Again and yet many times again I have seen a great fear of dying in the earlier stages of the last illness, but it was only a transitory phase, and ere long the kindly comforting of Nature brought peace to the mind and unconsciousness of pain long before the final passing had come.

"Nature is wonderfully beneficent, and with no niggard hand does she pour out from her pharmacy stores hypnotics more potent than the drowsy poppy, more rapid than the speedy chloroform, and more lasting than the charms of magic or of drugs. In forest and jungle, in the burning desert and on the lonely moor alike, the soothing voice of Nature is heard in the hour of death singing her lullaby of rest and peace and sleep profound.

"I believe that under all conditions and in all its manifold forms the angel of death is preceded by a handmaid bearing a bowl of the mystic water of Lethe, which she sprinkles with generous freedom as she passes. Death, then, is never seen and never known, and those who fear the pains