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Maps, plates, charts, etc., may be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate,- the method: Les cartes, planches, tableaux, etc., peuvent 6tre filmds d des taux de reduction diffdrents. Lorsque le document est trop grand pour dtre reproduit en un seul clichd, il est film6 d partir de Tangle sup^rieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images ndcessaire. Les diagrammes suivants illustrent la mdthode. 1 2 3 1 8 3 4 6 6 I" I IS' •'• ■"^ f-y •:•:! •■;'-':;--tl SPECIAL EDITION OF THE ,< .■-. «• Canada Lancet Commemorating the Meeting of the British Medical Association at Montreal, A'jgusf 28th, J 897. Western /^ssu ranee Go. HEAD OFFICES: Gor. Wellington and Scott Sts. TORONTO X^fta! (paid -p) - l,pOO,000.00 •/ ^ CHkAs^e^s over - 2,32^,0^.00 A^^^fnfiae (^r, ,^,300,00^00 Losses Paid Since / 0.00 . DIRECTORS . Hon. Gko. A. Cox, ■ 'Ny President. ^ \\*ii-e-Presiileiit .Tud M.'in. Director. Hon. S. C. Wood. Rout. Bkaty. ('■. I\., R. CocKiu'Ri^'c- II. N". H.MRP. 0IF ^IF '^ Evans & Sons, Limited, , . Wholesale Druggists . . Montreal. f-i]jM ^(T Wholesale Agents for Canada. IV TFIE MONTKEAL MEETING OF THE EMPIRE ELA8TI0 BANDAGE. SPIXIALLY ADAPTED FOR V.'.RICOSK VEINS. \Vi* invite the attention of the Meilieai anil Surj^ical Pro- fession to llie variv>iis merits combined in onr Hani.laM:>"^ : ist. ITS POROSITY— the »,'reatLst in the " Kmpire." It never eaiises itthinK". rash or ulceration under the bandajje. and. ITS ELASTICITY, which will enable the surjjeon or nurse to pu it on at any reijnired tension, and which will fol- low a swelh, ef up anil down, as the case may be, a feature imknown to aiiv other bandage. ird. IT.S AB^ORHKNT PKOPERTIES-greatest in the " r^nipire. ' 4th. I rS EASY APFMCATION to any part of the bod\. not beint;!: neccssar\ to told tiver, as with other bandages, as it follows itself with eipial uniformity around any part of the abdomen, .sth. ITS SELE-HOLDING QU.VLITIES. No K ther with pins, neeilles and thread, or strinjir- ^o tiresome to sur- ifeons, as simply tuckinf^ the etui utuler the last fold insures its permanent stav until its removal tor purposes ot cleanliness. (.th. The on'lv bandage that is Sl'PEKIOR TO THE I-.!. ASITC STOCKINC; for varicose veins. Send $1 for 3 in. by 5 yd. Bandage on approval. As an Abdominal Supporter with Button Inserted at the Navel. Is made i^l tlie same material, and possesses the same merits as the Empire Elastic UandaM:e and Abdominal Sup- porters, and is pronounced by all who have seen it to be the Beat In the World. All of our ^^lods are sent fre. b\ mail \ipon receipt of price, and mone\' refunded it not satisfactory, ^Intanls. $1.25, Children, $3.(;o. .Adults, $4,ik*. ^uppofEtt THE EMPIRE ABDOMINAL SUPPORTER l.s Superior to All Others for the Followingf Reasons : I St. It ;tdapts itself to e\'ery inovenietit of the bod>". ^jivinj^ striin^,-^ and even support, 2nd. It protluces warmth without Irritation or sweating^. It is perfectly ventilated. .ird. In pre^■nancy, corpulenc\, tiunors, or other cases ot abilomen. it supports weig-ht of body from the Sackbone, relieving the sinews ot their overwork. 4th. Its easy appliance (lace, and drawn on over liead or feet). i^th. It is cheap, dur.-ible. It can be washed when soiled, proper care bcinfjf taken to cleanse it in luke- w.irni water and dry in the shade. ;t^rln ordering;, give the measure of the abdomen. PRICES: Eig'ht Inches Wide, $2.50. Eleven Inches ^VIde, $3.00. All Silk, $10.00. Twelve Inches Wide, double pubber, $4.00. ♦ - V -;..-^ MANUFACTURED BY The Empire lilanufaciuring Go. 47 SPRING ST. LOCKPORT, N.Y., U.SA. I m I THE BUITISII MEDICAL ASSOCIATION. hIs are sent frev I'niy refundeil il Ailiilts, S4..«.. SUPPORTER for the ent of the body. ' irritation or nors, or other f body from the ' overwork. Irawn on over washed when inse it in hike- the abdomen. S3.00. Ilk. $10.00. le rubber. ring Go. M/ ^t& -Alt' •^J&i^^«" -^'^ «&'<• •^'^• ^^t' ^te ^'<- :>'& •>'<• •&'& "iife^fe.^'*- ^'4 -ito ^Ife •>''«• "S'^ "^'^ ^S& "^'<- "^fc I JOHNSON & JOHNSON'S i| ^ ASEPTIC DRESSINGS BI-STERILIZED Are prepared in Aseptic Labormories by opepatives skilled in aseptic work under the SUPERVISION OF Graduate Surqical Nurses. They are beady foh use without other pre- paration. In till' roliabilily of a ilii-ssiiij^ is hoiiiul up tlie lifo of .In- paliiMil aiul tlu' ii-pula- tion ot tin' surjii^eoii. Spi-liiv Johnson & Johnson. Write for Copy of "Asepsis Secundum Artem." GILMOUR BROS. & CO., Sole Agents, - Montreal. m •»i? ^ ^ tlf^/if W •»»<• •»!'!• ^I«" '/i? ^f? -Vi?^!*" •?!«• •Jiv'^i;" tti- -Vl? •Jl^' •>»«• •>1«=^^ •7if •?!«• •>!«• -tS^" ««'' We invite your attention to our Alpha Atomizers. Note the tube in its different views, A B C D. This tube is simply an air reser- voir into which the bulb empties itself. By gradually collapsing it forces the air forward, the full sup- ply of air not being entirely ex- hausted before the bulb again fills the tubes. WE CLAIM that our ALPHA ATOMIZER." produce ^n abso- lutely continuou s spray with less labor to the hand than any other single bulb atomizer upon the market. Examine the cut and you will see how simple yet effective it should be. For Sale by the Drug Trade, or Alpha Rubber Co., Limited, Illustrated Cat alogue on Application. ^ ^ lVrnnfT<>al VI THE MONTllEAI. MKETING OK ABBEY'S Effervescent SALT. 'm^'V^'-wv^^^ A pleasant effervescent aperient, taking the place of nauseat- inif mineral waters. Recognized and prescribed by eminent members of the profession in Great Britain and Europe. 'V^'%^%^%^%^^%%' THE ABBEY EFFERVESCENT SALT GO. LIMITED 592 CRAIO STREET MONTREAL I^UM" mwm> T THE BRITISH MEDICAL ASSOCIATION. Vll akehttrst Sanitarium Oakville, Ont. n a u seat- eminent CO. ( I ■* I ^HE attention of the Medical Profession is respectfully drawn to the ttniform success attending the treat- ment of Alcoholism and Morphine Addiction ....at Oakville. A prominent medical man in Toronto has, within the last few weeks, paid a glowing tribute to its efficacy in the case of one of his patients who had long since lost susceptibility to the ordinary form of treatment employed, and whose life seem'ed to hang in the balance. Many came to Oakville in the last stages of the malady, yet of these but two cases in four years have proved to be beyond reach of our treat- ment — a record well deserving thoughtful consideration of the profession. For Terms Apply TORONTO OFFICfz, 54 King street East, or, THE MEDICAL SUPERINTENDENT, Oakvi/ie. VIU THK MONTREAL MEETING OF .>lfc.Mf. .Al<..»lfc^te Sli. Mt. AV^ vM/, .iff. Of, ^fe ^to ^to ^W. .jlfr ^If. ^W. ^fe .aie. dU. .4t<. f S\irgi'iy. MiiUll I'liiversity. You have been welcomed to tl\e Dominion of Cannda by the Noble Earl who is the worthy representative of our beloved Queen ; you have l)oen welcomed to the Province of Quebec, to which thi.s city belongs, by our eloquent and justly-esteenied Lieutenant Oovi-rnor : the Chief Magis- trate of our city has given you " Cued 7ail/e faUihe' in a manner in wiiich only an Irislnnan with such a gi'eat sympathetic heart as ho pos- sesses can give : and now I rise to welcome you on behalf of the medical profession in Canada, and to thank you for the honor conferred on this city and country by your presence here to-day. Would that I could find suitable language in which to thank you also for the high honor you have tione me in electing me to preside at this great meeting of the British Medical Association, an honor which is appreciated none the less by the consciousness that it is not a jiersonal matter, but a compliment to Canadiaii medicine. This meeting of the British Medical Association in Canada is an event which wdi serve still more to impress upon the memory of our people the year 1NI)7, the year of the Diamond Jubilee of our beloved Sovereign, Queen Victoria. In no part of her vast Empire — not even in its very Iteart— did her subjects celebrate the great event with more enthusiastic loyalty an(i devotion than in Canada, especially in this province, the home of the French-Canadians. We Canadians of both tongues love and honor our (^ueen. Long may slie live ! Deeply, too, have we appreciated here the splendid reception accorded in the old home to our Premier, the Plight Hon. Sir Wilfrid Laurier, whose distinguished bearing and grace of manner eminently fitted him for the important part it was his pecu- liar privilege to play in the magnifici'ut ceremonies of the Jubilee. A French-Canadian, Sir Wilfrid's presence in England as the chosen repre- sentative of the Dominion was an object lesson to the Empire and to the world in the harmony existing between the two nationalities which com- prise tlie Canadian people. And here let me express on behalf of every representative from the British Isles, and resent, the genuine plea- .sure we feel in having among us on this memorable occasion .so many of ''^ THE BRITISH MEDICAL ASSOCIATION. our brethren from the United States. This only proves the cosmopolitan character of our profession : this is only another recognition of the unity of medicine. Legislators may squabble, the air may be filled with \v\\i\ alarms, and war may appear imminent day by day, but our relations are not disturbed in the sliglitest degree — our interests are cimmon — we are kinsmen in science ; we go forward liand in hand, irrespective of race or creed or color, having one intent only ; the advancement of our noble profession, and through that the amelioration of the ills of mankind. It is my privilege al.so to welcome the representative of another Re- public, La Belle France, to whose gifted men of .science our profession is so greatly indebted. This gentleman, who bears the credentials of his Government, and otticially represents the great nation of which lie is so bright an ornament, is known far and v/ideas the Professor of Physiology in the University of France, Dr. Charles Richet. In coming to Canada it cannot be said, nor will he feel, that he comes to a foreign country, for in the Province of Quebec he will find another France, with a delightful mingling of the old and the new : his own beautiful language spoken with all the grace and purity of the old regime. But we are further honored by the presence among us today of the most illustrious surgeon of our generation, Lord Lister, who stands for the rise and zenith of modern suigery. It has been well and truly said that as long as surgery is scientifically di-cussed Lord Lister's naine can- not fail to be mentioned. We have only to compare the surgeiy of the time before 187.S with the surgeiy as practised to-day to appreciate all tiiat he has done for the science. Can it be for a moment questioned that Lord Lister has made operative proceedings possible which only twenty-five years ago would have been considereil criminal :' Undoubt- edly, the most powerful agency in the development of surgery in this century has been the introduction of the antiseptic and a.-teptic methods of wound treatment which he initiated. It is due to his efforts that surgical wards have been freed from pyicmia, and the mortality of lying- in hospitals reduced to the limits of normal ))arturition. For the |)ast twenty ^ars honors many and great have betiu showered upon him. Ox- ford, (yambridge, Edinburgh, Ciasgow, Dublin, Toronto, and now McClill, vied with one another in hastening to do him homage. Our Sovereign in conferring upon him the richly deserved distinctions which he bears with such gracious dignity only gives expression to the general feeling of his countrymen throughout the Fmpire and his admirers the world over. We are glad, I say, to have him with us to-day ; his presence is an intel- lectual sl;imulus and an energi/ing force in our ilelilerations. It is, I understand, an unwritten law of the Association that the Presi- dent shall not in his address encroach upon the topics which belong by right and usage to the readers of the main addresses and to the presi- dents of the various .sections. I have observed that the majority of my predece.ssors have contented themselves with discoursing on objects and circumstances of local interest: they descrilie the town or city i.: which the meeting is held, or perhaps they discuss questions of a public char- acter. In the absence of an address on pul)lic medicine, others have taken that for their theme. It has '> ;(!n my unhappy lot i;o select and THE MONTKEAL MEETING OK consider subjeccs only to find in quick sviecession that they had already been appropriated, either by the Association Journal, in describing so fully Montreal and its surroundings, or by the editors of the Official (Juide or Souvenir, who have given a very compre'-.ensive description of Oanada, or by some of the gentlemen who preside over the sections, who, I have been led to understand, purpose discussing ([uestions of medical edutation. I fear, therefore, that what I have to say this afternoon will fall far short of the brilliant presidential addresses which members of this Association have been accustomed to in other years. Indeed when I look at the long roll of eminent men who have been my predecessors in this high '.office — men oftentimes distinguished for their literary gifts as well an for their exalted position in the medical world — I confess that I marvel at my temerity in accepting so great a responsibility. In speak- ing of iiiy predecessors allow me especially to refer to the retiring Presi- ortance and .'iii^'niticante. I have no he.si- jtation in I'xpressing my belief that the British Medical Association will |be an important factor in bri))ging to a successful i.s.>i(ie that great scheme jsof Imperial Federation wliicii now exercises ti e minds, ant and varied extent, Canada may be .said to be the posses- sor of several climates. Taking Solly's classification as to position, we have in Canada all the three lanil climates, the low, the medium, and the hi^h. The first has an elevation U|> to 2,500 feet, the second up to 4,500, and the third from 4',o(J0 upwards. As to temperature and humidity, Canada comes under the category of "cold, moderate and dry." HK.\I.TI1 KESOlCrS. In the eastern region of the J^omiidon there are at least two localities which have been proved to possess many of the (lualities which consti- tute a climate for convalescents from fevers and other depressing diseases, and also for consumption in the incipient stage. I refer to the region in the Province of Quebec among the Laurent ians north of this city, of which the village of Ste. Agathe is the centre ; the other being the Mus- kolns of the British Empire have a climate eijual to that of Canada. In fact, his statistics prove coriclusively that out of every l.OO) of the troo) is stationed at the various garrisons throughout the Kiiipire the percentage constantly inetliective from sickness was smal- ler in this country hy? percent, than at (Jibraltar, which was then taken as the type. 1 tliink it can \m satisfactorily proved that Canada is ex- pressly fitted to develop a liardy race capable of great endurance. The races of the British Isles and the French race have certainly not degen- erated here. Kingston proved this very conclusively some years ago by (observations made upon the medical students attending the various schools in this city. He found that the lumbar strength of the iiritish Canadian of the third generation exceeded by 20 lbs. that of the recently arrived Knglish and Scotch students. But the French-Canadian of the tenth generation did better tlian all by nearly 80 lbs. Not only has the French-Canailian increased in strength, but also in height and weight over the original Normandy stock. Has the intellectual inii)rovement in our people kept pace with the physical :' We are a moilest ])eople, i)ut I tliink we can say it has. We liave a very resjiectaMe literatui'e of our own; but the best intellect of the country is as yet absorbed in the practical affairs of life, and has too seldom found expression in art and literature. Jt is not very long since a distinguished American litterateur, Charles Dudley Warner, gravely at- tributed what he called the literary inactivity of Canada to tlie coldness of the climate. He said, in short, that the cold benumlied our intellect- ual (acuities, and we had to spend so nmch of our energy in trying to keep warm that none was left for any other purpose. It must be admit- ted tliat if we measure the intellectual capacity of our people bj' the number nf books produced in Canada the result is not all we might desire : Imt the climate is not to blame. Kspecially it is not the cold, for the winter is the season devoted pre-eminently to intellectual effort and intellectual amusements. If Mr. Warner had said that the heat of our siinnner was an unfavorable factor in our intellectual life he would not have shot (piite .so wide of the mark ; he would not have been right, but he would not ha^'e been (piite so w rong. 'I'he very vicissitudes of our climate, by training the system to endure severe physical conditions, must react favorably upon the mental attitude. CANADIAN si'.AS. We liave in Canada several mineral .-pringsof undoubted therapeutic value, and they are pretty generally distributed all over the Dominion, although differing materially in teiiiperature and composition. The best known Canadian spas are Caledonia, the St. Leon and the Plantagenet Springs, in the Province of Quebec, and the Banff' Springs in Alberta. Other springs in the Province of Quebec are the Abenakis and the Cax- ton. Besides these there are at least three or four artesian wells or |ioned in mil prac- Itisfcics to It'iiual to It. out of •ougliout jas sinal- |en taken la ia ex- ^e. The It degen- .s ai^o by various Hritish iTCi'utly M of the lias the weiirht vith the as. W'o ell>'ct of has too \n^ since lively at- coldness intellect- ryintr to »e adiuit- b}' the e miirlit he cold, al effort heat of e would in right, tudes of iditioiis, fl-peutic miinion, "he best tdirenet VIberta. le Cax- 'ells or '•^ THE BKITISH MEDICAL ASSOCIATION. IS springs. Of these the chief are the Luurentian Spring in the east end of this city (a mild alkaline water with sodium bicarbonate as its predominat- ing ingredient,, and the Radnor, a well of some considerable repule situ- ated in the County of Champlain. This was discovered a very few years ago when boring for water to supply the workpeople engaged at the well known Radnor Forges. It has been likened to tht, German Seltzer, many of the properties being alike. It bids fair to become a rival in time of the celebrated Apollinaris water, to which it is preferred by many. The well is over 400 feet in depth. In the Province of Ontario the chief springs are the Winchester and the Preston, and those in the town of St. Catharines, near Niagara Falls. The best known and the most popular are the Caledonia Springs, situated on the line of the Canadian Pacific Railway about midway between Montreal and Ottawa, and about nine miles from the Ottawa River. They consist of four springs — the gas, the saline, the white sulphur, and the intermitting or Duncan spring The first three are situated within a distance of three or four rods of erch other, and the mouths of the latter two are not more than four feet a^mrt. The intermitting .spring is situated about two miles from the others. This is so named because the discharge of gas is not regular, some min- utes elapsing between the period.s of quiescence and disturbance. The average temperature of these sjirings is about 4G° F. The intermitting spring has the largest percentage of chloride of sodium, and differs from all the others in possessing a greater portion of chlorides of calcium and magnesium. It has also nearly twice the proportion of carbonate of mag- nesium that the others contain. It has been found that taken judiciously and under advice these waters have a remarkable effect in subacute and chronic rheumatic conditions. People suffering thus are found Hocking to Caledonia ftom all parts of this continent and even South America, especially during the months of July and August. Gouty conditions depending upon liver disturbances also yield very readily to the.se wafers. The waters of St. Leon and Plantagenjt are similar in many respects tc thosejti.st described, and as a rule suit the same class of patients. All the springs so far mentioned yield cold waters. But Canada also possesses the most famous thermal springs on this continent. Banff, now a picturesque town magnificently situated in the heart of the Rocky Mountains, yet within the limits of that division of the North- west Territories known as Alberta, has become one of the noted health resorts, although frecjuented more on account of its remarkable thermal springs than for its c imatic advantage.s. The town is bu' on the banks of the Bow and Spray rivers, two large glacier streams, and is surround- ed by mountains towering many thousands of feet above the level of the sea. The winter is shoit, beginning in December and ending in Febru- ai'y, and is nuch milder than in Ontario. Very little rain falls, and the days as a rule are bright and cloudless. Prolonged periods of warm weather are experienced during winter. March and April are variable : May is varm and bright: June is the month in which the greatest rain- fall occurs: July, August, September and October are very warm and very dry, with cool nights. At all seasons with the exception perhaps of June the air is dry and notably aseptic. It is positively stated that no M 14 THE MONTREAI- MEETING OF case of malaria or tuberculosis has ever been known to originate at Banff. Independently of the springs, then, Banff has much to recommend it from a climatological standpoint. The far-famed Thermal Springs of Banff were only discovered some 15 years ago, during the construction of the Canadian Pacific Radway. At its source in the mountain side it has a temperature of 127' F., and the air is charged for some distance around with the steam emitted from the [)Ool to which the water flows. The most recent analysis shows it to contain the following ingredients : — Calcium sulphate ofi.So Magnesium sulphate 12..S9 Calcium CHibon.itc '^29 Sodium sulphate 15.(50 Sodium carbonate. . Mo. 73 Silica traces. Organic matter traces. Tlie waters of Banff have been u.sed with great benefit in rheumatism, gout, sciatica, and glandular affections, in certain forms of skin disease, and especially, it is thought, in tubercular affections of the skin and mucous membrane. Aided by the admirable climatic conditions the wat- ers have also been found to benefit in a marked manner functional dis- eases of the liver, stoma, h and kidneys, and tubercular joint affections. Jn debilitated constitutions from any cause the activity of the skin is noticed to be increased, the heart and vascular system strengthened, and the muscular and neivous sj'stems much improved intone. Rachitic and delicate children are nnicli benefited by the Thermal Springs. 'I'his seems a large order : but the therapeutic effects of these springs have bee.i carefull}^ studieiiion that the educational training for persons who propo.sed to enter the medical pro- fession should be largely .scientific: I'ot merely or even principally be- cavisean acquaintance with the elements of physical and l)iological science is absalutoiy essential to the conqiiehiMision of human physiologs' and pathology ; but still mure liecause of the value of the discipline attbrded l)y practical work in the.se departments in the process of observation and experiment, in inductive reasoning and in manipulation. The subjects in the science cuiriculum might be specially selected for the future medical stndeiit. Of course it may be said in favor of the arts course that nuiny of the subjects such as physics and chemistry constitute rn^ % 1« THE MONTREAL MEETING OF part of the curriculum ; but then calculate the loss to the future surgeon of that training of the hand and eye which would lead him up to be a skilled operator; or to the scientitic physician whose complicated instiu- ments of precision employed in the diagnosis of disease need some mech anical knowledge for lioth their use and repair. Besides, the number of those has been increasing in number and complexity with the increase scientific knowledge. But can we not make a new departure ; can we not urge that a special «cientitic education be arranged by the universities for those who desire to enter the medical profession ? Such a course would embrace element- ary Latin and Greek, French and German, physics, chemistry, biology, psychology, elementary mechanics, a practical laboratory course on elec- tricity and drawing. After two years' study, thi.s might entitle the suc- cessful candidate to the degree of Licv: '.i/iate in Science. Something of this kind has been recently attempted in the University -of McGill. By a special arrangement with the Faculty of Arts it is now possible for students to obtain the degree of B.A. along with M.D., CM., after only six years of study. It has been decided to allow the primary subjects (anatomy, physiology and chemistry) in medicine to count as subjects of the third and fourth years in Arts. It follows, then, that at the end of four years' study a student may obtain his B.A. degree and have two years of his medical course completed. The last two years of study are, of course, devoted to the third and fourth year subjects in medicine. A certificate of Licentiate in Arts will be given along with the professional degree in medicine to those who previous to entrance upon their professional studies proper have completed two years in the Faculty of Arts, and have fully passed the prescribed examinations therein. Hy this plan also during the first two years of the Arts course the medical student practically completes his studies in physics, chem- istry, botany and elementary psychology. This scheme is still in the ex- perimental stage, but there is every reason to believe that it will result satisfactorily. What deters so many from taking a full course in Arts or Science before entering Medicine is the length of time consumed be- fore the doctorate degree is reached, although I hope the time is not far distant when every graduate in Medicine in Canada shall of necessity be also a graduate in Arts or Science. I might state that the standard for the ordinary matriculation examination for entrance to Medicine exacted by all universities and licensing boards in this country is, with one or two exceptions, very high. I doubt if the requireiients in this way of the Medical Council of Great Biitain are any higher. Now as to the purely profemional portion of medicine, I might state that we have in the Dominion of Canada no fewer than 1 1 medical schools, including one for women only, all having the power of granting degrees, and all connected directly or by attiliation with university bodies. To enumerate tlu-m : Beginning with the Atlantic Provinces, we have in Halifax the m^sdictl school attached to Dalhousie University, the only medical 8ch(>ol in the Maritime Provinces ; in this Province there are four schools, Laval in Quebec, Laval in Montreal, Mc( Jill and Bishop's in Montreal : in Ontario four schools, namely, the Royal College ture surgeon m up to be a cated instiu- souie mech le number of e increase hat a special e who desire ace element- try, biology, ur>se o'l elec- titlc the suc- i University rts it is now I M.D., CM., the primary to count afs ;hen, that at B.A. degree le last two fourth year vill be given » previous to id two years xaminations Arts course lysics, chem- II in the ex- t will result urse in Arts snsumed be- ne is not far necessity be itandard for cine exacted ivith one or this way of might state 1 1 medical of granting I university i Provinces, University, is Province MclJiil and jyai College THK BRITISH MEDICAL ASSOCIATION. 17 pi Physicians and Surgeons, Kingston : the University of Toronto Med- ical Faculty, Trinity Medical College, and the Ontario Women's Medical College, in Toronto ; in London, Ontario, the Western University Med- ■|cal Faculty : and lastly, in Winnipeg, the Manitoba University Faculty '^f Medicine. All told, we had in Canada during the last winter sessions ■pSG teachers, including professors, lecturers and demonstrators, and 1,73G jstudents. Tne tendency for the past two years has been to increase the iteaching staff qu'^e out of proportion to the increased number of stu- jdents. Takinoj McGill we find that there are in the present year 58 iteachers for 388 students, being a proportion of nearly one to eight. La- |val, in Montreal, has 3G ieachers and 197 students, a still greater propor- ;«tion. The Toronto School of Medicine had during the past year 41 Heachers and 29;} students. We find that this proportion compares well |with the larger schools in the United States: thus, in 1893, there were fin Harvard Medical School 71 teachers to look after 471 students; at the J Columbia Medical College in New York, with 6(J1 students, there were ;;>105 teachers (1 to G) ; in the University of Pennsylvania the teaching Cstatt" in the same year comprised only 84 members with 825 students, ''being a little over 1 to 10. What does this mean ? Ten yeans ago when '. ^IcCiill had 237 students, a staff of 23 professors and demonstrators was :' considered sutticient. Why are so many more thought necessary now-a- 4 days? The number of subjects taught has not increased very much. 't The answer is that the subjects are ditl'erently taught, the old-fashioned '' daily didactic lectures are now given two or three times a week only : ' although I should be sorry to see them further reduced in number, I bc- ' lieve that so many are absolutely nec.^isary. It is in the dissecting room, the chemical, physiological, therapeutical and pathological laboratories that we see the change. These which before were for tlie most part only ;" side shows " are now made to hum with the priictical work wiiich is \ (lone witiiin them, while demonstrators are moving about busily engaged J in examining and instructing. ,; In clinical teaching also we have made marked advances. A creation •; of the last few years is the clinical demonstrator, who takes small classes , ijf .students into the wards or the out-door department of our hospitals ; and gives them that "bedside instruction" which is so essential, leaving \: the clinical professor to ileal with the full cla.sses in the lecture or operat- ",'. ing room. Thus each student is enabled personally to examine the case, ■ to study the physiognomy of disease, and to make deliberate, thorough aiid systematic examination. He thus learns to use his special senses ; and gets into careful habits of observation which, once thoroughly ac- ; ((uired, will be found to contribute largely to future success. With this in view we encourage students to attend the out-patient ilepartment of the hospital as early as the .second year. V In order to make the clinical instruction more complete and more thorough, chemical and ''acteriological laboratories have been added to ^^ the pathological departments of our hospitals. Thus i^ vill be seen that : laboratory methods everywhere prevail, all with the idea of developin:^ ..'■ the scientific spirit in students and of cultivating methods of thought THE MONTR KA I. MEKTINC <.K WILLI/VM OSLER, M.D., F.R.C.P., I'rofessnr of M'iiiiiiie, Joints l[„pki„s fnivenily, liailimorc. THE BRITISH MEDICAL ASSOCIATION. 23 THE ADDRESS IN MEDIQNE. BY WILLIAM OSLER, M.D., F.R.C.P., I'rofesaor of MLMliuiiie, .Johns Hopkins University, lialtinion BRITISH AIEDICINE IN GREATER BRITAIN. To trace successfully the evolution of any one of the learned professions would require the hand of a master, of one who, like Darwin, could com- l)ine the capacity for patient observation with philosophic vision. In the case of Medicine the difficulties are enormously increased by the ex- traordinary development which belongs to the history of the present century. The rate of progress has been too rapid for us to appn ciate, and we stand bewildered, and, as it were, in a state of intellectual giddi- ness, when we attempt to obtain a broad comprehensive view of tlie sul)- ject. In a safer " middle flight," it is my purpoae to dwell on certain of the factors which have moulded the profession in English-speaking lands bevond the narrow seas — of British medicine in Greater Britain. Even for this lesser task (though my attiliations are wide and my sympaihies deep), I I'ecognize the limitations of my fitness, and am not unaware that in my ignorance I shall overlook much which might have rendered less sketchy a sketch necessaiily imperfect. Evolution advances by such slow and imperceptible degrees that to those who are part ot it tiie finger of time scarcely seems to move. Even the great epochs are seMom apparent to the participators. During the last century neither the colonists nor the mother country appreciated the thrilling interest of the long fought duel for the possession of tliis con- tinent. The acts and scenes of the drama, to them detached, isolated and independent, now glide like dissolving views into each other, and in the vitascopo of history we can .see the true secpience of events. That we can meet here to-day, Britons on British soil in a French province, is one of the far-off results of that struggle. This was but a prelu(ie to the other great event of the eighteenth century, the revolt of tiie colonies and the founding of a second great English-speaking nation, in tlie words of Bishop Berkeley's prophecy : " Time's noblest offspring. " Surely a unique spectacle that a century later de.scendants of the actors of these two great dramas should meet in an English city in New France ! Here the American may forget Yorktown in Louisburg, the Enjilishman Bunker Hill in Quebec, and the Frenchman both Louisburg and Quebec in Chateauguay ; while we Canadians, ICnglish and French, in a fm-giv- ing spirit, overlooking your unseemly quarrels, are only too happy to welcome you to our country, this land on which and for which you have so often fought. SI 24 THE MONTKEAL MEETING OF » r ^ (Jnce, and only once, before in the history of the world could such a L'ath( riiij.' as this have taken place. Divided though the Greeks were, a Hellenic'sentinient of extraordinary strength united them in certain as- semblies and festivals. No great flight of imagination is required to pic- ture a notable representation of our profession in the fifth century, B C, meeting in such a colonial town as Agrigentum under the presidency of Etiipedocles. Delegates from the mother cities, brilliant predecessors of Hippocrates of the stamp of Damocedes and Herodicus, delegates from the sister colonies of Syracuse and other Sicilian towns, from neighbor- ing Italy, from far distant Massilia, and from still more distant Panti- capaeum and Isb-ia. And in such an assemblage there would have been men capable of discussing problems of life and mind more brilliantly than in many subseijuent periods, in proportion as the pre-Hippocratic philosophers in things medical had thought more deeply than many of those who came after them. We Knglish are the Modern Greeks, and we alone have colonized as they did, as free people. There have been other great colonial empires, I'lmmician, Roman, Spanish, Dutch and French, but in civil liberty and in intellectual freedom Magna Gra^cia and Greater Britain stand alone. The parallel so often drawn between them is of particular interest with reference to the similarity between the Greek settlements in Sicilj' and the English plantations on the Atlantic coast. Indeed, Freeman Srtys : " I can never think of America without something suggesting Sicily, or of Sicily without something sugge.sting America." I wish to use the parallel only to emphasize two points, one of difference and one of re- semblance. The Greek colonist took Greece with him. Hellas had no geographical bounds. " Massilia and Olbia were cities of Hellas in as full a sense a.s Athens or Sparta." While the emigrant Britons changed their sky, not their character, in crossing the great sea, yet the home- stayers had never the .same feeling towards the plantations as the Greeks had towanls the colonial cities of Magna Gnecia. If, as has been shrewd- ly surmi.sed, Professor Seely was Herodotus reincarnate, how grieved the spirit of the " father of History " must have been to say of Englishmen, " Nor have we even now ceased to think of ourselves as simply a race inhabiting an island off the northern coast of the continent of Europe." The assumption of gracious superiority which, unless carefully cloaked, smacks just a little of our national arrogance, is apt to jar on sensitive colonial nerves. With the expansion of the Empire, and the supplanting of a national by an imperial spirit, this will become impossible. That this sentiment never prevailed in Hellas as it did later in the Roman Em- pire, was due largely to the fact that in literature, in science and in art the colonial cities of Greece early overshadowed the mother cities. It may be because the settlements of Greater Britain wei-e things of slower growth, that i* took several generations and several bitter trials to teach a lesson the Greeks never had to learn. The Greek spirit was the leaven of the old world, the workings of which no nationality could resist. Thrice it saved western civilization, for it had the magic power of leading captivity captive, and making even captive conquerors the missionaries of its culture. What modern medi- I THE BRITISH MEDICAL ASS'JCIATION. 25 oine owes to it will appear later. " The love of science, the love of art, the love of freedom — vitally correlated to each other and brouj^ht into ' nj^anic union," were the essential attributes of the Greek peniuH (Butcher). Wliile we cannot claim for the Anglo-Saxon race all of these distinctions, it lias in a high degree that one which in practical life is the most valu- jilile, and which has been the most precious gift of the race to the world — the love of freedom. " Of freedom in her regal seat Of Kngliiiid." It would carry one too far afield to discu.ss the differences between the native Briton and his children scattered so widely up and down the earth. In Canada, South Africa, Australia and New Zealand types of the Anglo- Saxon race are developing whicli will difler as much from each other, and from the English, a.s the American does to-day from the original stock; but amid these diff'eiences can everywhere be seen those race ()ualities which have made us what we are — " courage, national integrity, steady good sense, and energy in work." At a future n)eeting of the Association, perhaps in Australia, a professional Sir( harles Dilke, with a firm grasp on the subject, may deal with the medical problems of (heater Britain in a manner worthy of tlie Address in Medicine. My task, as I mentioned at the outset, is much less ambitinus. CouM some one with full knowledge patiently analyze the chaiacter- isti.s of British medicine he would find certain national traits sufficiently di.stinct for recognition. Three centuries cannot do very much (and that period has only just passed since the revival of medicine in Kngland), l)Ut the local conditions of isolation which have been singularly favorable to the development of special peculiarities in the national character have not been without effect on the medical profession. I cannot do more than touch upon a few features, not distinctive but illustrative, featuies whicli may be useful as indicating the sources of infiiience upon Greater Britain in the past, and which may, perhaps, be suggestive as to lines of progress in the future. Above the fireplace in Sir Henry Acland's study are three panelled portraits of Linacre, Sydenham and Harvey ; the scroll upon them reads: Literae, Praxis, Scienfia. To this great triumvirate, as to the fountiiin heads, we may trace the streams of inspiration which have made British medicine what it is to-day. Linacre, the type of the literary physician, must ever hold a unique place in the annals of our profession. To him was due in great measure the revival of Greek thought in the sixteenth century in England, and in the last Harveian Oration, Dr. Payne has pointed out his importance as a forerunner of Harvey. He made Greek methods available ; through him the art of Hippocrates and the science of Galen became once more the subject of careful, first-hand study. Linacre, as Dr. Payne remarks, " was possessed from his youth till his death by the enthusiasm of learn- ing. He was an idealist, devoted to objects which the world thought of little use." Painstaking, accurate, critical, hypercritical, perhaps, he re- mains to-day the chief literary representative of British medicine. Neither in Britain nor in Greater Britain have we maintained the place 2« THK MONTUEAL MEETING OF < ! in th(; worIecluded laboratory career. Tliucydides it was who said of the (Jreeks tliat they possessed " the power of thinking before they acted, and of acting too." The same is true in a high degree of the English race. To know first what lias to be done, then to do it, comprises the whole pliiloso|ihy of practical life. Sydenham — Amjluv lumen as he has been well called — is the model practical physician of niod-'^rn times. Linacro led Harvey back toCialeti, Sydenham to Hippocrates. The one took Greek science, the other not so much Greek medicine as Greek methods, particularly intellectual fear- lessness, and a certain knack of looking at things. Sydeidiam broke with authority and went to Nature. It is an extraordinary fact that he could have been so emancipated from dogmas and theories of all sorts. He laid down the fundamental yn'oposition, and acted upon it, that "all diseases should be descrilied as objects of natural history." To do him justice we must remember, as Dr. John Brown says, " in the midst of what a mass of errors and jirejudices, of theories actively mischievous, he was placed, at a time when the mania of hypothesis was at its height, and when the practical part of his art was overrun and stultified by vile and silly nostrums." Sydenham led us back to Hippocrates ; I would that we could be led oftener to Sydenham ' How necessary to bear in mind what he says about the method of the study of medicine. " In writing, therefore, such a natural history of diseases, every merely philosophical hypothesis should be set aside, and the manifest and natural phenomena, however ^ 28 IHK MONTHEAL MEETING OF imi ^\ The usefulness of imnutc, should be noted with the utmost exactness. . , , this procedure cannot be easily over-rated, as compared with the subtle inquiries and trifling notions of modern writers, for can there be a short- er, or indeed any other way of coming at the morbific causes, or of dis- covering the curative indications, than by a certain percei)tion of the peculiar symptoms i Hy these steps and helps it was that the father of physic, the great Hippocrates, came to excel, his theory being no more than an exact description or view of Nature. He found that Nature alone often terminates diseases, and works a cure with a few simple medicines, and often enough with no medicine at all." Well, indeed, has a recent writer remarked, "Sydenham is unlike every previous teacher of the principles and practice of medicine in the modern world." He, not Linacre or Harvey, is the model Briti^h physician, in whom were concentrated all those practical instincts upon which we lay such stress in the Anglo-Saxon character. The Greek faculty, which we possess, of thinking and acting has enabled us, in spite of many disadvantages, to takT the lion's share in the great practical advances in medicine. The three greatest scientific movements of the centuiy have come froni Ger- many and France. Bichat, Laennec and Louis laid the foundation of modern clinical medicine; Virchow and his pupils of scientific pathology ; while Pasteur and Koch have revolutionized the study of the causes of diseases : and yet the modern history of the art of medicine could almost be written in its fulness from the records of the Anglo-Saxon race. We can claim every practical advance of the very first rank — vaccination, ana'sthesia, preventive medicine, and antiseptic surgery — tiie " captain's jewels in the carcanet " of the profession, besides which can be placed no others of ecjual lustre. One other lesson of Sydenham's life needs careful conning. The Eng- lish Hippocrates, as I said, broke with authority. His motto was: " Thou Nat ne ml my (loddess ; to lliy law My •^?rvices are liouiul.'' I'^ndue reverence for authority as such, a serene satis-faction with the ,s^^^as (yuo, and a fatuous objection to change have often retarded the progress of medicine. In every generation, in every country, there liave been and ever will be laudatores temporis acti, in the bad sense of that phrase, not a few of them, men in high places, who have lent the weight of a complacent conservatism to bolster up an ineffectual attempt to stay the progress of n^w ideas. Every innovator from Harvey to Lister has been made to feel its force. The recently issued life ot Thomas Wakley is a running commentary on this spirit, against the pricks of which he kicked so hard and so effectually. But there are signs of a great change. The old Universities and the Colleges, once the chief ofl'enders, have been emancipated, a.iid remain no longer, as Gibbon fouml the m, steeped in port and prejudice. The value of authority j}er ,se has lessened enor- mously, and we of Greater Britain have perhaps suffered as the pendulum has swung to the other extreme. Practice loves authority, as announced in " the general and perpetual voice of men " (Hooker). Science must •ever hold with Epicharmus, that a judicious distrust and a wise scepticism :»: THE BRITISH MEDICAL ASSOCIATION. 2» are the sinews of the understanding. And yet the very foundations of Viclief in almost everything relating to our art rest upon authority. The piactitioner cannot always be the judge — the responsibility must often rest with the teachers and investigators who can only learn in the lessons of history the terrible significance of the word. In the treatment of fevers the fetters of a thou.sand year.':) were shattered by .Sydenham, shat- tered only to be riveted anew. How hard was the battle in this century iigainst the entrenched and stubborn foe ! Listen to the eloquent plead- ings of Stokes, pleading, as did Sydenham, against authority and against the bleedings, the purgings and sweatings of fifty years ago. " Thougli Ills hair be grey, and his authority high, he is but a child in knowledge, and his reputation an error. On a level with 'i child so far as correct appreciation of the great truths of medicine is concerned, he is very dif- ferent in other respects, his powers of doing mischief are greater: he is far more dangerous. Oh I that men would stoop to learn, or at least cease to destroy." The potency of human auth.ority among " the powers that be " was never better drawn than by the judicious Hooker in his section on this subject. " And this not only with ' the simpler sort,' but the learnedcr and the wiser we are the more such arguments in some cases prevail with us. The reason why the simpler sort are moved with authority is the conscience of their own ignorance ; whereby it cometh to pass that having learned men in admiration, they rather fear to dislike them than know wherefore they .should allow and follow their judgments. Contrariwise with them that are skilful, authority is much more strong and forcible ; because they only are able to discern how just cause there is why to some men's authority so nuich should be attributed. For which cause the name of Hipprocrates (no doubt) were more effectual to persuade even .such men as Galen himself than to move a silly empiric." Sydenham was tailed "a man of m.i"v doubts," and therein lay the secret of his great stiength. Passing now to the main (luestion of the development of this IJritish medicine in Oreater Britain, I must at once acknowledge the impo.ssibility of doing justice to it. I can only indicate a few point." of importance, and 1 must confine my remarks chiefly to the American part of Greater Britain. We may recognize three distinct periods, corresponding to three dis- tinct waves of nifluence : the first from the early migraci(,n.s to about J!S20, the .second from about 1820 to 18(J0, and the third from about 1860 to the present time. The colonial .settlements were cimteniporaneous with the revival of medicine in England. Fellow students of Harvey at Cambridge might have sailed in tiie Muebec in 175LI and 1820 the Emilish population had been increased by the settlement of Upper Canada, chieHy by United Empire Loyalists from the United States, and after the war of 1812 by settlers from the Old Country. The physicians in the sparsely settled districts were either young men who sought their fortunes in the new colony, or were army surgeons wiio had remained after the revolutionary war or the war of 1M2. The military element gave for some years a very distinctive stamp to the profession. These surgeons were men of energy and aVjilit}', who hud seen much service and were accustomed to order, discipline and regulations. Sabine in his History of the Loyalist):! refers to tiie Tory i)roclivities of the doctors, and says that they were not so much disturbed as the lawyers and clergymen. Still, a good many of them left their liomes ' for conscience' sake," and Canitf', in his History of the Profession in Upper Canada, gives a list of those known to have been among the Uniteil Kinpire Loyalists. The character of the men who controlled the profession of the new colony is well nhown by the proceedings of the Medical Board, which was organized in 1819. Drs. ^L'lcauley and Widmer, both army surgeons, were the chief members. The latter, who has well been termed the father of the professioii in Upper Canada, a man of the very highi^-st character, did more than any one else to promote tin; progress of the profession, and throughout his long career his efforts were always ilirected in the proper channels. On looking through Caniff's most valuable work one i,s much impressed by the sterling worth and mettle ot these old army .surgeons, who in these early days formed the larger part of the profession. The minutes of the .Medical Board indicate with what military discipline the candidates were e.xamined, and the percentage of rejections has probably never been higher in the history of the province than it was in the tirst twenty years of the existence of the Board. One picture on the canvas of those early days lingers in the memory, illustrating many of the most attrac- tive features of a race which has done much to make this country what it is to-day. Widmer was the type of the ilignified old army .surgeon, scrupulously punctilious and in every detail regardful of the proprie- ties of life. ' Tiger ' IJunlop may be taken as the very incarnation of that restless, roving spirit which has di-ivcn the Scotch broadcast upon the world. After tighting with the Connaught Rangers in the war of 1M2, campaigning in India ch^aring the Sangnr of tigers— hence his 8oubri(|uet ' Tiger,'— lecturing on Medical Jurisprudence in Edintmrgh, writing for Iilackvvood, editing the British Press and the Telescope, in- troducing Beck's Medical .lurispiudeni'e to English readers and figuring as director and pmmoter of various companies, this extraordinary char- acter appeal s in the young colony as ' Warden of the lilaek Forest ' in the employ of the Canada Company. His life in the backwoods at Cair- THE BRITISH MEDICAL ASSOCIATION. 33 jw it to-day. Tlie discovery of ' moinunt it is true, in a sys- fyooms with anatomical changes. braid, his Nodes Amhrosiaiuv Canadensis, his fainous ' Twelve Apostles' as he called tlie mahogany liquor stand (each bottle a full cjuart), his active political life, his remarkable household, his many eccentricities — are ^'ley not all pourtrayed to the life in the recently issued " In the Dai/s of the Canada Cumpan;/ " f turning now to the second period we may remark in passing that the niiK'teenth century did not open very auspiciously for British medicine. Hunter had left no successor, and powerful as had been his inHuence it was too weak to stem the tide of abstract speculation, with wliich Cul- len. Brown and others Hooded the profession. Xo more sterile period exists than the early decades of this century. Willan, a great naturalist in skin diseases, with a few others, save it from other oblivion. Tlie methods of Hippocrates, of Sydenham and of Hunter had not yi.'t been made available in every day work. The awakening came in France, and such an awakening ! It can be compared with nothing but the renais- sance in the sixteenth and seventee-'" .ituries, which gave us Vesalius and Harvey. ' Citizen ' Bichat am 'ssais led the way, but Laennec really created clinical medicine as v'c auscultation was only an accident, O' ■ teuiatic study of the correlation of .sy Louis, Andral ami Chomel extended the reputation of the French School, which was maintained to the full until the sixth decade, when tlie bril- liant Trousseau ended a long line of Paris teachers, whose audience had been world-wide. The revival of medicine in (ireat Britain was directly due to the French. Bright and Addison, Graves and Stokes, Forbes and Marshall Hall, Jjatham and Bennett were profoundly ali'ected by the new movement. In the United States Anglican influence did not wane until after 1820. 'translations of tht^ works of Bichat appeared as early as 1802, and there were reprints in subsequent years, but it was not until 1823 that the drst translation (a reprint of Forbes' edition) of Laennec was issueil. Broussais' works became very popular in translations after 1830, and in the Journals from this time on the change of allegiance be- came very evident. But men rather than books diverted the trend of professional thought. After 1825 American students no longer went to Edinburgh and London, but to Paris, and one can say that between 1830 and 1800 every teacher and writer of note pas.sed under the Gallic yoke. The translations of Louis' works, and the extraordinary success of his American ])upils, a band of the ablest young men the country had ever seen, added force to the movement. And yet this was a period in which American Medical literature was made up largely of pirated Englisli books, and the Systems, Encyclopedias, aucl Libraries, chielly reprints, testify to tlie zeal of the publishers. Stokes, Graves, Todd, Benntitt, and Williams furnished Anglican pap to the sucklings, as well as strong meat to the full grown. In spite of the powerful French iuHaence the text- books of the schools were almost exclusively English. In Canada the period from 1820 to 18()0 saw the establishment of the English Universities and Meiiicai Schools. In .Montreal the agencies at work were wholly Scotch. The McGill Medical School was organized by Scotchmen, and f lom its inception has followed closely Edinburgh methods. 34 THE MONTItKAL MEETINCJ OF M 'l"he Paris influence, less personal, was exerted chiefly through Englisii and Scotch channels. The Tapper Canada Schools were organized by men with English aftiliations, and the traditions of Guy's, St. Bartholomew's, St. Thomas's St. Ciieorges', and of the London Hospital, rather than those of Edinburgh, have prevailed in Toronto and Kingston. The local French influence on British medicine has been very slight. In the early decades of the centui-y, when the cities were smaller, and the intercourse between the French and English somewhat closer, the recip- rocal action was more marl-. 3d. At that period English methods became somewhat the vogue among thd French: .several very prominent French- (Janadians were lulinburgh graduates. Attempts were made in the meilical journals to have communications in both languages, but the fusion of the two sections of the profession was no more feasible than the fusion of the two nationalities, and the development has progressed along sepa- rate lines. The third period da,tes from about 18(J0, when the influence of German medicine began to be felt. 'J'he rise of the N'ienna School was for a long time the only visible result in Germany of the French renaissance. Skoda, tlie German Laennec, and Kokitansky, the German Morgagni, influenced English and American thought between ISIO and 18G0, but it was not until after the last date that Teutonic medicine began to be felt as a vitalizing power, chiefly through the energy of Virchow After the translation of tlie Cellular Pathology \)y Chance (LSGO), the way lay clear and open to every young student who desired inspiration. There had been great men in Berlin before Virchow, but he made the town on the Spree a Mecca for the faithful of all lands. From this period we can date the rise of German influence in the profession of this continent. It came partly through the study of pathological histology under the stimu- lus given by Virchow, and partly through the development of the special- ties, particularly diseases of the eye, of the skin, and of the larynx. The singularly attractive -courses of Hebra, the oi-ganization on a large scale in Vienna of a system of graduate teaching designed especially for foreigners, the remarkable expansion of the German laboratories, com- bined to divert the stream of students from France. The change of alle- giance ^yas a deserved tribute to the splendid organization of the German Universities, to the untiring zeal and energy of their professors, and to their single-minded devotion to science for its own sake. In certain aspects the Australasian settlements present the most inter- esting problems of Greater Britain. More homogeneous, thoroughly British, isolated, distant, the; must work out their destiny with a less stringent environment than, for example, surrounds the English in Canada. The traditions are more uniform, and of whatever character have Altered through British channels. The professional population of native-trained men is as yet small, and the proportion of Graduates and Licentiates from the English, Scotch and Irish Colleges and Boards guar- antees th . dominance of Old Country ideas. What the maturity will show cannot be predicted, but the vigorous infancy is full of " crescent prom- ise." On looking over the flies of Australian and New Zealand journals one is impressed with the monotonous similarity of the diseases in the THE BRITISH MEDICAL ASSOCIATION. 35 Antipodes to those of (jreat Britain and of this continent. Except in the matter of parasitic affections and siiake-hites, tlie nosology presents few distinctive (juaiities. The proceedings of the four Intercolonial Con- gresses indicate a high level of professional thought. In two points Australia has not progressed as other parts of Greater Britain. The sat- isfactory regulation of ])ractice, so early settled in Canada, has been beset with many difficulties. Both in the United States and in Au^stralia the , absence of the military element, which was so strong in Canada, may, in ' part at least, account for tlx; great difference which has prevaileil in this matter of the State license. The other relates to the (piestion of ethics, to which one really does not care to refer, were it not absolutely forced upon the attention in reading the journals. Elsewhere j)rofessional s(|Uabbles, always .so unseemly and distressing, are happily becoming very rare, and in Great F^ritain and on this side of the water we try at any rate to wash our dirty linen at home. In the large Australian cities dif- ferences and dissensions seem lamentably common. Surely they must be fermented by the atrocious system of election to the hospitals, which plunges the entire profession every third or fourth year into the throes of a contest in which the candidates have to .solicit the .suffrages of from 2,000 to 4,000 voters ! Well, indeed, might Dr. Batchelor say, in his ad- dress to the Fourth Intercolonial Congress: " It is a .scandal that in an}- British community, mucli less in a community which takes pride in a progressive spirit, such !>, pernicious system shouUl survive for an hour." t)f India, 'of Vishnu-land,' what can one say in a few minutes '. Three thouglits at once claim i-ecognition. Here, in the dim dawn of history, with the great Aryan people, was the intellectual cradle of the world. To the Hindoos we owe a debt which we can at any rate acknowledge : and even in medicine many of our traditions and i)rc in- fluences, Anne.sley and Ballingall, Twining, Morehead, Waring, i^arkes, C'unningham, Lewis, Vandyke Carter and many others have nobly up- helil the traditions of Harvej'^ and of Sydenham. On the great epidemic diseases how impoverished would our literature be in the absence of their contribution.s. But then there comes the thought of ' tlie petty done, the undone vast ' when one considers the remarkable opportunities for study which India has presented. Where else in the world is there such a Held for observation in cholera, leprosy, dysentery, the plague, typhoid fever, malaria, and in a host of other less important maladies ? And what has the British Government done towards the scientific investigation of the diseases of India ? Until recentl}' little or nothing, and the proposal to found an institute for the scientific .study of di,sea.se8 has actually come from the native chiefs ! The work of Dr. Hankin and of Professor Haff- kine, and the not unmixed evil of the brisk epidemic of plague in Bom- bay, may arouse the officials to a consciousness of their shortcomings. While sanitary progress has been great, as shown in a reduction of tlie 36 THE MONTREAL MEETING OF i mortality from 69 per mille before 1857 to 15 per mille at presuiit, many problems are still urgent, as may be gathered from reading Dr. Harvey's presidential address in the proceedings of the Indian Medical Congress. That typhoid fever can be called the " scourge of India," and that the in- cidence of the diseasi' should remain so high among the troops, points to serious sanitary delects as yet unremedied. As to the prevalence oi venereal disea.ses among the soldiers — an admission of nearly 500 mille tells its own tale. On reading the journals and discussions one gets the impression that matters are not as they should be in India. There seems to be an absence of proper standards of authority. Had there been in each Pres- idency during the past twenty years thoroughly equipped Government laboratories in charge of able men, well trained in modern methods, the contributions to our knowledge of epidemic diseases might have been epoclv-making, and at any rate we should have been spared the crudeness which is evident in Sduie of the work (particularly in that upon Malaria^ of zealous but badly trained men. In estimating the progress of medicine in the countries comprising Greater Britain, the future rather than the present should be in our minds. The strides which have been taken during the past twenty years are a strong warrant that we have entered upon a period of excep- tional development. When I see what has been accomplished in this city, in the short space of time since I left, I can scarcely credit my eyes. The reality exceeds the utmost desires of my dreams. The awakening of the profession in the United States to a consciousness of their respon- sibilities and opportunities has caused unparalleled changes, which have given an impetus to medical work whicli has already borne a rich har- vest. Within two hundred years wlio can say where the intellectual centre of the Anglo-!*axon race will be ? The mother country herself has only become an intellectual nation of the first rank within a period altogether too short to justify a prediction that she has reached the zenith. She will probably reverse the history of Hellas, in which the mental superiority was at first with the colonies. At the end of the next century ardent old-world students may come to this side ' as o'er a brook,' seeking inspiration from great masters, perhaps in this very city ; or the current may turn towards the schools of the great nations of the South. Tnder new and previously unknown conditions the Africander, the Australian, or the New Zeaiander may reach a develo|)ment before which even the ' glory that Wfs Greece ' may pale. Visionary as this may appear, it is not one whit more im{)robable to-day than would have been a prophecy made in 171)7 that such a gathering as the present would be possible within a century on the banks of the St Lawrence. Meanwhile to the throbbing vitality of modern iiiedicine the two great meetings held this month, in lands so widely distant, bear elo(iuenC testi- mony. I'ree, cosmopolitan, no longer h.ampered by the dogmas of schools, we may feel a just pride in a profession almost totally emanci- pated from the bondage of error and prejudice. Distinctions of race, nationality, color and creed are unknown within the portals of the tem- ple of Aesculapius. Dare we dream that this harmony and cohesion so THE BRITISH MEDICAL ASSOCIATION. 37 lany ivey's jress. le in- fts to ee 01 lille that |je an 'res- lent the been jness aria; rapidly developing in medicine, obliterating the strongest lines of divi- sion, knowing no tie of loyalty but loyalty to truth — dare we hope, I say, that in the wider range of human affairs a similar solidarity might ultimately be reached :' Who can say that the forges of Time will weld no links between man and man stronger than those of religion or of country ? Some Son of Beor, touched with a prophetic vision, piercing the clouds v/hich now veil the eternal sunshine of the mountain top, some spectator of all time and all existence (to use Plato's expression), might see in this gathering of men of one blood and one tongue a gleam of hope for the future, of hope at any rate that the great race, so dominant on the earth to-day, may progress in the bonds of peace — a faint glimmer, perhaps, of the larger hope of humanity of that day when " the common sense of most shall hold a fretful ' world ' in ave." But these, I fear, are the dreams of the closet student who knows not the world nor its ways. There remains for us. Greater Britons, of whatsoever land, the bounden duty to cherish the best traditions of our fathers, and particulaily of the men who gave to British medicine its most distinctive features, of the men, too, who found for us the light and liberty of Greek thougiit — Lin- acre, Harvey and Sydenham, those ' ancient founts of inspiration,' and models for all time in Literature, Science and Practice. 3.S THE MONTREAT, MEETING OF THE ADDRESS IN SURGERY. BY W. MITCHELL BANKS, M.D., EDIN., Krllow urnl Memlitr nf ('oiiiuil of the K(._val Ciilleye of Suiguons of Kii^jliind ; Suigoon to the Livirpool Koyal IntiiiiiaiV : Kmcritiis Professor of Anatomy, I'liiverHity ('ollegc, Liveipiiol. THE SURGEON OF OLD IN WAR I am indeed oreatly honored by having to deliver to you to-diiy aiv Address in Surjery. Fortunately ior me the title is a wide one, and I shall take advantage of that fact to diverge from tlie strict considerp.tion of surgical disease, and shall offer you instead a brief sketch of some of the most notable work done of old by a body of members of our profes- sio;., who have never received their due reward — those, namely, who have devoted their lives to the succour of the sick and the wounded in war. MILITARY SURGEONS IN THE ROMAN ARMY. Twelve months ago my friend, Dr. Barnes, of Carlisle, ex-President of this Association, made me acquainted with a remarkable paper by tlm late Sir James Simpson, entitled, Was the Roman Army provided with Medical Officers ? — a paper exhibiting such profound learning, so charm- ingly written, and so little known that I need not make any apology for acquainting you with some of its chief points of interest. The most careful investigations have failed to make out from theix* writings whether the Romans regularly appointed physicians and sur- geons to their armies or not, although nearly every other question relat- ing to their military organization has been treated of, sometimes very fully. Curiously enough, what little information we possess on the subject comes mainly from mortuary or from votive tablets. Borcovicus, in Northumberland — now called Housesteads — was one of the principal stations on the line of Hadrian's wall. Here, about seventy years ago,, was found a monumental tablet, now in the Newcastle museum. On it is the following inscription : D M ANICIO INGENUO MEDICO OHD COH I TUNOR VIX AN XXV d(iis) m(anirus) ANICIO INGENUO MEDICO ord(inario) coh(ortis) PRIMAE TUNGR(oRUM) VIX(IT) AN(NOS) XXV The First Tungrian Cohort is known to have been present at the bat- tle of the Mons (irampius, and to have served at Castlecary, at Cramond,. near Edinburgh, in Cumberland, and at Housesteads. The tablet is highly THE BRITISH MEDICAL ASSOCIATION. 39 As Sunlight : is to Darkness is the condition of the woman wlio has heen relieved from some functional disturhance to lier state liefore relief. Don't voii know, Doctor, that there are few cases that pay the physician so well as those of women- and the Doctor that relieves one woman lays the foundation for manv more such cases — all women talk, and your patient will tell her friends. ASPAKOLIXH COMi'OUXD gives relief in all cases of functional disturbance — Leucorrhita, Dys- menorrhiva, etc., and in the cases it does not cure it gives relief. We will send you enough ASPAROLIXK COM- POUND — free— to treat one case. Dr. Breton, of Lowell, Mass, says : " I wish to inform you of the very satisfai'tory resuhs obtaiiu-tl from my use of Asparoline. I have put it to the most crucial tests, anil in every case it has done more than it was requireil to do. I recommend it in all cases of dysmenorrhcva." ♦ • « ♦ « « FORMULA : Parsley Seed, - - - - Grs. 30 Black Haw, (bark of the root) " 60 Asparagus Seed, - - - "30 Qum Quaiacum, ... '•30 Henbane Leaves, - - - " 6 AromatiCS. To Each Fluid Ounce. * • * • • ♦ Prepared Solely by Henry K» Wampole & Co»; Phapmaceutical Chemists, PHILADELPHIA, PA. 40 THE MONTREAL MEETING OF tl ornamented, and aiitiiiuarians hold that a rabbit and round bucklers carved in tlie upper part, which are eiiiblemH of Spain, show that the younf^ military doctor was probably a native of that country. From various works treat inff of Roman inscriptions Simpson was enabled to find that tour more tablets, in which surgeons of cohorts are mentioned, existed, i'hey were louml at Rome. One of them is a votive tablet, the inscription upon which intimates that it was dedicated by Sextus Titius Alpxander to /Esculapius and to the safety of his fellow soldiers. It wjis cut in the year of the consulNhip of F. Flavius Sabinus, which is known to have been A.D. H'.\. As the Roman legion consisted of ten cohorts, it is interesting to know that there were not only medical othcers attached to each cohort, but also one attachefl to the legion — a sort of surgeon- colonel, as we shoulil call him nowadays. Three tablets have been dis- covered in which the viedicus legiunis is mentioned. One found at Verona was a tablet rai.sed by Scribonia Faustina to her dearest husband, J. Caelius Arrianus, medical officer to the Second Italian Legion, who died at the age of 41) years and 7 months. Furthermore, Simpson routed out of Mommsen's Latin inscriptions of Naples a tablet, now in the Dresden collection, whicli was founci in the Klysian fields near Baiae, close to the l\jrtus Julius, which was the station of a division of the Imperial fleet. The inscriptum tells that M. Satrius Longinus, medicus duplicatorius to the Trireme L'upid, and the heirs of those freed by Julia Veneria erected the tablet to the manes of that deserving lady. The term duplicatorius means that by reason of long or meritorious service he was entitled to double pay and rewards. These little gleanings from Simpson's paper show what an interesting one it is, and one is astonished at the labor that must have been expended in digging up the information contained in it. AMBUOISE PAHE. Hundreds of years went past before there came upon the scene any military surget)n of note, but when he did appear he was a man of trans- cendent merit — the illustrious Ambroise Pard. From 1.517 to 1590, for seventy three years, he lived a long and incessantly actire life, the con- temporary of Vesalius, the immediate predecessor of Harvey. We have only time to glance at the soldier-surgeon side of Park's life. For over thirtj' years he followed the wars under four kings of Franc? — Henry the Second, Francis the Second, Charles the Ninth, and Henry the Third, with intervals of a few years at home in Paris. Perpignan, Mertz, Ver- dun, Rheims, Hesdin (where he was taken prisoner and had to write tr his wife for his ran.som), St. Quintin, La Fere, Amiens, the taking of Rouen, Dreux, Moncontour — these are but some of the bloody battles and sieges at which he was present. Through them all his humanity, his love of his profession, his independent character, and his jovial, frank disposi- tion carried him safe, and made for the son of the poor country joiner warmer friends among the greatest and noblest warriors of France. Even that miserable monster, Charles the Ninth, loved the Huguenot sur- geon, and when the awful day of St. Bartholomew came, Part- was spared to tend his wretched master through the brief term of agonized and re- THE URITISH MKDICAL ASSOCIATION. 41 |klers the rom d to ned, the itius was own Its, it hed eon- dis- ;it and, died out iden the eet. I to cted rius to aper ibor ined niorseful life tliat was given him. The description in Dumas' novel, the 2\vo Dianas, of the wpund of the famous warrior, Duke of Guise, where thi. lance entered above the t-ye and came out between the nucha and the left t:'r, breakin(;r short ott, and how Pan' liif,'ged it out, with the chance that when it did come, one terrible gusli of bl^od would finish his illus- trious patient's life and his own career at the same moment — the picture of all this \A real history. Amid all the splendid work, both anatomical and surgical, which Par^ did the application of the ligature to bleeding arteries is of course that with which his name will be for ever associated. In this day of grace it is impossible for us to imagine the horrors that awaited a wretched man so soon as his limb was cut oft' and the proce.ss of stopping the bleeding began. Think of the raw and excjuisitely sensitive stump exposed to the red hot cautery or plunged into boiling pitch ! For tiiis frightful treatment Par6 substituted the ligature, which in our own day, employed in the form of an aseptic animal material which the tissues (juietly ab- sorb, has practically I'eached the pitch of perfection. In his time, too, there was a fixed belief that the danger from gunshot wounds arose from the poison of the gunpowder conveyed on the bullet To destroy this poison the treatment was tr pour into the wound boiling oil in which elderwood bark had been st ved. On one occasion, not having this in- fernal concoction at hand, Pare used a cold mixture of yolk of egg, oil of roses, and turpentine to his ^/ounded soldiers. He passed a sleepless night from dread that this v/ould injure those to whom it had been ap- plied, and his delight next day was propoi tionately great when he found that lie had had but little pain, while their wounds wei'e free from in- flammation and swelling. This was his panacea for wounds ever after- wards. There are of course persons who wish to make out tliat he was not original in the matter of the ligature. He himself says this about it : " Taught me as I interpret it by the suggestion of some good Angel, for I neither learnt it of my masters, nor of any other man. And thus I wish all chirurgions to doe. For it is not in our Art as it is in civill affaires, that prescription, law, or authority should prevail over right reason." But these cavillers have doubtless never heard of an ancient proverb which says that there is nothing new under the sun. In spite of them thq world will ever believe in a glorious trio — Par<5, the Frenchman, who invented the ligature ; Morton, the American, who discovered ana-sthetics; and Lister the Englishman, who introduced antiseptics. In the fulness of years, puoaessed of affluence, and surrounded by friends, died Pard, the whilom poor barber-chirurgeon, now a Councillor of State and Sur- geon-in-Chief to the King. One final touch will perhaps reveal a senti- ment that permeated and guided his every labor. On one occasion, after the successful treatment of a wounded officer, he made thiswise and rev- erent remark, afterwards adopted as his motto: " Je le pansay ; Dieu le ijuarist" — I ti'eated him; (Jod cured him. ROHEUT CLOWES. Coming to England, a surgeon who saw no little fighting was Robert Clowes, who was born somewhere about 1540 and died in 1604. He li 1 42 THE MONTREAL ME^TINO Or" served in France in the army commanded by the Karl of Surrey, aiu' was afterwards for several years iu the navy. He then began practice in London, and was made surgeon to .-^t. Bartholomew's and Christ's Hos- pitals. But, after being about fourteen years in civil practice, he W!l^ despatched by Queen Elizabeth's orders into the Low countries to atten I upon the Karl of Leicester, Comufander of Her Majesty's forces. He wa^ at Zutphen when Sir Philip Sydney was iollt by sea and land. A good half of this treatise is occupied with a reconl of surgical cases of note which he had treated, and this renders the work very entertaining, ijiasmuch as we get an ac- curate and positive knowledge of everything that was done for a wound- ed man in those days, while there are numei'ous little side touches very characteri.stic of life at the time it was written. He tells us, for instance, of " The cure of one Master Andrew Fones.a merch;int of London, which, being in a ship at the sea was .set upon by the Elushingers, in which fight he was very tiangerously wounded with a gunshot. " There is " The cure of one Henry Rhodes, one of the waiters at the Custom House, he being upon the river of Thames a skirmishing with his peece, and by reason the peece had certain Haws in it, did breake into many peeces, and made a great wound upon his chin, and carried away a good part of the man- duble and the teeth withail ; moreover it did rend his hand greatly : all which I cured without maime or deformitie." There is " An ob.sorvation for the cure of the master of a Hoy that had both his legs fractured and broken into many peeces with an iron bullet, shot out of a great basse or har(|uebu88e of crccke at the sea by a Pyrat or sea rover." T'hese few titles v.i)! give you an idea of Ciowes's clinical cases. The importance which attaches to them, and the reason why they constitute a distinct advance in the H.-ience of surgery, is that the author gives his actual ex- periences and tells us what he did to his patients, whereas at that period the tendency was to write endless commentaries on ancient writers, to whose every dictum the blindest and most unreasoning respect was [aid. PETER LOWE. Contemporary with Clowes was a most interesting character — Maister Peter Lowe — who was born in Scotland about 1550, and lived some sixty or sixty-five years, reaching well into the seventeenth century. Like many of his countrymen, he went to France when very young, where he lived for some say ten, some twenty, years. Then he returned to Glas- gow, where he lived and died a citizen of much renown, having obtained in 1599 from King James the Sixth a charter for the Faculty of Physi- of THE BRITISH MEDICAL ASSOCIATION. 43 ciana and Surgeons of Glasgow, which he thus founded. A few yeans ago Dr. Finlayson puhli.shed a most charming account of Maister Peter. His most important work is termed A Discourse of the whole art of Chiruryery. covrpiled ht/ Peter Loice, Scottishvuin, Doctor in the Facultij of Chirurgerie at Paris, and ordinary Chyrurgiun to the French King and Navarre. The tir.- '•■ i line cum cerato refri^erantiw Galeni quantum aufficit, fiat ungiientum." Curious to note how, even in men of distinct ability like Lowe, a com- plete ignorance of pathology dragged them into the perpetration of the silliest empiricism. WOODALLS " \ rATIC'UM." In 1628 appeared the first work in England specially devoted to mili- tary vand naval surgery. Some eleven years later a second edition ap- peared, and this is its title : Viaticum, being tlte Pathway to the Surgeon ^ Vhest. containing chirurgical instructions for the younger sort of sur- geons imployed in the service of His Majestic or for the Common- Wealth ujion any occasion .irhatsoerer, intenaed for the better curing of wounds made by Gunshot, by John Woodall. A perusal of the Viaticum shows that Woodall was a very practical surgeon and an eminently religious man, and the way in which he mixes up pills and piety is sometimes very diverting. After some excellent general advice to the surgeon s mate, including a warning against " being given and dedicated to the Pot and 'i'obacco-pipe in an unreasonable measure," — he enumerates the instruments for the Surgeon's Chest, including among others Catlings, Rasouis, i'rapans, Trafine, Lavatories, Cauterising Irons, Storks' bills, Ravens' bills, Crowes' bills, Terebellum, Probes or flamules, Glister Sir- ings and (what would have utterly damned his book in the present day) "one bundle of small German instruments." Then comes a list of medi- cines under the heading Unguentum, Acjua, Sol, Oleum, Chemicall Oylea, Syrups, Conserva, Electurine, and so on, winding up with a list of the Simples, and of the Herbs and Roots most fit to be carried. A long and careful description of the uses of the instruments and drugs follows, and then come chapters on wounds, apostumes. fractures, dislocations, ampu- tation, scurvy, the plague, gangrene, and other topics. He observes that the cauterising irons had gone soujewhat out of fashion, and he did not use them much himself " because of the feare they put the Patient into, and for speech of people who are ready to scandalise an Artist upon each occasion." In amputation, moreover, they are " now wholly forborne for reasons aforesaid, and for that a more pleasant course is known better for the patient and the Arti.st by making a ligature upon the veine, wound or artery, which is the binding of each end thereof, being .first caught and holden with some fit instrument, and tied with a sure and strong thread." Woodall advances the cure of wounds a distinct step, once more put- ting lis under an obligation to the aoldier-surjieon. This he does by sharply attacking all through his A-orks the inordinate and meddlesome use of strong caustics. He says that he had seen men lamed by the need- less use of caustic medicines, even in slight wounds to which if an old wife had only applieii her one salve for all sores, no such thing had hap- pened. " They will not see a wound incarne and red and good flesh to grow, but straight they slander it of pride, and call it proud flesh, like their owne ; and then must at the fairest Precipitate or Vitriale burnt goe to work, yea, though the Patient be lame^for it, or at the least the griefe put bock again." "'•"HJM!". THE BRITISH MEDICAL ASSOCIATION. 45 1111." pom- the RICHAKU WISEMAN. I wish I had time to give you a proper account of the adventurous life of Richard Wiseman, who has been termed the Father of English Sur- gery, and that not without reason. Born in 1G20, dying in l()7lj, he lived in the time of Charles the First, of the Coininonwealth, and of Charles the Second. He was a naval surgeon to begin with, serving in the early part of his life in the Dutch navy. Being, however, a devoted Royali.st he served with the armies of Charles the First, and after his death went into exile with his son in France. He was present at the battle of Wor- cester, where he was taken prisoner, and afterwards conlined in Lambeth House for awhile. During the Commonwealth he was naturally under a cloud, and even went off for three years to serve in the Spani.sh navy. At the restoration the King did not forget his old surgeon, who had done and suffered »o much in his service, but appointed him his surgeon-in- ordinary, and afterwards serjeant-surgeon. The first edition of his work, printed in 1672, is quite a small book, and is entitled A Treatise of Wounds, but it afterwards expanded into a very large volume. Nothing reveals a man like his own words, and so in trying to give you an idea of these old worthies I have let them tell their own stories. Wiseman believed in the need for giving stimulants to a man who was in the habit of taking them, if that man was in a dire strait. After des- cribing the parlos case of a certain patient, it seems that the " man swooned and complained that he could not live without wine. I complied with his desire ; he drank again as he pleased, his sickness went off, his wound digested, and he cured. This I have often seen in .some of our Dunkirkers at sea, who draidc extraordinarily, and were full of drink in our sea fights. 1 could scarce ever cure them without allowing them wine, and thereby their spirits were kept up, and I had the liberty to bleed them as I thought fit." From this it is clear that the old saying about Dutch courage Iuks a distinct origin in fact. But if the unhappy Batavians were liable to be bled at once by the lance of the enemy and the lancet of the surgeon, one can hardly wonder at their taking some- thing to keep their spirits up. When speaking of gunshot wounds, he insists upou the bullet being searched for and extracted at once. " The part is at first dressing, with what diligence you can, to be cleared of all such Foreign Bodies as have made violent Intrusion into it, while the patient is warm with the heat of Battel, and the wound fresh and very little altered by either Air or Accidents, so that less pain must necessarily follow upon the extraction. In the Armada Naval dc Dun Hny [ship fore M I '^y the Republican Army of the Rhine under Custine. Now, the ambulances of these days were obliged to remain about a league from the army, and the wounded were only picked up after the fighting was done, (ieneral Custine was a man who moved his troops very rapidly, which made mat- ters worse for the wounded. This greatly affected Lari-ey, who set to work and devised a new ambulance hung on springs, and combining great strength with lightness. Such carriages were termed avibulances va- in iitex. They could keep up with the advanced guard of the army with the speed of Hying artillery, and they carried otf the wounded almost as they fell. Larrey had early perceived the enormous advantage a wound- ed man got by having his fracture set or his bleeding stopped as rapidly as possible, and by then getting a roof over his head before night set in. General Beauliarnais, in a despatch to the Convention, made special men- tion of " Surgeon-Major Larrey and his comrades with Hying ambulances, whose indefatigable care in the healing of the wounded has diminished those atHicting results to humanity which have generally been insepar- able from days of victory, and has e.ssentially .served the cause of human- ity itself in preserving the brave defenders of our country " The staff' of a flying ambulance was about 840 in number. Fur each division there were four heavy carriages and twelve light ono.s. Some had two ami others four wheels, and they were furnishetl with mattress'.'s. In Napo- leon's Italian campaigns the}' came greatly to the fore, and the great man vvn direction 200 amputations were performed, wore there were neither couches nor blankets nor coverinir of nny iciiid, and where the food < on- sisted of horseflesh, cabbage stalks, and a few potatoes; think of cnld so intense that the instruments recpiisite for the operations too often tumbled from the powerless hands of the Frei.ch sur^'eons. Think of tlie savage Cossacks, hovering about all the while, and waiting their chance to kill the surgeon and the wounded man equally with tlie combatant. Then came the passage of the Beresina. 'J'ake an incident of it. Among the wounded was General Zayoncliek, who was over (iO years of age. His knee was crushed, and without amputation the saving of his life was im- possible. It was performed under the enemy's Hre, and amid thick fall- ing snow. There was no shelter except a cloak, which two officers held over him whde the operation was being performed : but the surgeons did their work with such coolness and dexterity that the old general survived, and died fourteen years afterwards Viceroy of Poland. Larrey succeeded in getting over the Beresina with the Imperial Guard, but di.scovered that the requisites for the sick and wounded had been left on the other side. At once he reeros.sed the river, only to tini! stay your Idood. To ciii'c yon snii: lie will have wattliful eie. Ami with siiili wiglits he means to live ami die, So that »i,Mine you must anginent his store, And having this he will iei|uesl no more. NOTES AND COMMENTS. The Montreal meeting of the Britisli Medical Association was in every respect the most hrilliant and snccessfiil of the annual gatherings of this body, from the social as well as from the scientiHc point of view. The fact that this is the first occasion during its Go years of existence that a meeting has been held outside the limits of the United Fvingdom marks its exceptional character, and the lavish hospitality bestowed upon the British members and American guests will long be remembered by them. The admirable arrangements made for their reception and comfort must have entailed great etimts on the part of the various committees, whose couitesy and ki Ine.ss have been appreciated l)y so many during the week. Nor shoidd mention be omitted of the considerate thoughtfulness which was shown by members of the Reception Couniiittee in meeting the visitors as they landed at Quebec and Montreal, as each contingent arrived, so that all lelt that ihey bad come among friends who were bent on doing everything to make their visit pleasureable. By Monday most of the mend'crs had arrived in Montreal, some coming from the Toronto meeting of the British Association, and others, who had arrived in Canada during th»> previous week, had tilled up their time by visits to Quebec, the Saguenay, Toronto, Niagara, and elsewhere. The dinner given by the President of St James's Club, on Monday evening, to the otticers of the Association and a large number of guests, formed a pleasant prelude to the hospitalities of the week. Amongst the company were the Governor-General of Canada (the Earl of Abetdeen), the Lieutenant-Governor of Quebec (Sir Adolphe Chapleau), Lord Strath- cona and Mount Koyal, Sir William Kingston, Sir William Van Home, the Mayor of Montreal, Prof. Ch. llichet of Paris, Sir Walter Foster, M.P. ; Mr. C. G. Wheelhouse, Mr. Macnamara, Dr. Barnes, Dr. Saundby, Dr. Dawson Williatus, Dr. Parsons, Dr. Stephen Mackenzie, I'rof. Adami, Prof. W. Osier, Dr. Leech, Mr. Malcolm Morri.^, Drs. Keen and Tyson of Philadelphia, Dr. Shattuck of Boston, Dr. Welch of Baltimore. The pro- ceedings were of a most genial and enthusiastic order, the President pro-, posing the toasts of the Queen, the Governor-General and Lieiitenant- EH TIIK HUITISH MEDICAL ASSOCIATION. 53 with y, who undertook to lay it before the council of the Association. The President then delivered hia inaugural address, ...id tlie proceedings terminated by a hearty vote of thanks to Dr. Roddick for his address, which was moved by Lord Lister and seconded by Sir James Grant. 54 THE MONTUKAL MEETINO OF I f ' i The Irilliant reception given by the Goveinoi-Geneial at Jiaval Uni- veiHity on Tiieslay evening attbided tlie members of the Asscciation thi- ui»|iort unity of aniiiainting themselve.s with this famous institution. After the rece|)tion a meeting was held in the hirge hall, presided over by Dr. Rottot, Dean of tlie Medical Faculty, when Prof. Ch. llichet, the dele- gate of the French Government and of the Faculty of Medicine of Paris, delivered an address ujion "The Work of Pasteur at\d the Modern Con- ception of Medicine." It is hardly possible to conilense this brilliant and eloquent plea for the recognition of the services rendered to medicine by Bcience. The work of Pasteur, he said, was a convincing demonstration of the fact that it is by experimental science alone that medicine has made and can make any progres.s. He traced the steps of Pasteur's life- work, connnencing with his early analysis by polarisation of the two forms of tartaric acid which led to his memorable demonstration of the true nature of fermentation, which, as Prof. Richet said, opened a new world to science. Then came his series of experiments disproving the doctrine of spontaneous generation, and conclusively showing that organic fluids undergo no change until living germs gain entrance into them. This was the first step to the establishment of the microbic theory of dis- ease, proved in the first instance by Pasteur's research in 18(37 on silk- worm disease, and importing into pathology a fact which has revolution- ized medicine. Nor did Pasteur's work stop here : his culminating discovery of the principle of vaccination is known to all. " Fermentation, "infection, contagion, vaccination; here in four words we learn the work " of Pasteur. What more need I say ? Do not these four words possess, " in their simplicity, unequalled eloquence ? " Thus did Prof. Richet sum up the debt which medicine owes to Pasteur's experimental researches ; extended as this has been through Lister by the victories of antiseptic surgery, and by Pasteur himself in his discovery of the treatment of hy- drophobia. Prof. Richet continued to show the close connection between science and medicine, which is daily demonstrated, by citing certain ex- amples of new discoveries that could not have been made had reliance been placed on clinical observations alone, such as treatment by animal extracts (e.g., thyroid treatment of cretinism), the Roentgen Rays, pancre- atic diabetes, serum therapeutics, and concluded an address, which throughout was characterized by remarkable lucidity and eloquence, by pointing out how much still remains to be done in the search after truth by men of v^cience for the perfection of medicine. On Tuesday evening, at the Windsor Hotel, a banquet was given to Lord Lister by the members of the Montreal Medico-Chirurgical Society, the president of the Society, Dr. Geo. Williams, occupying the chair. The Governor-General sat on the right of the chair, the guest of the evening on the left, and amongst those present were Sir William Hingston, Sir James Grant, Prof. Richet, Dr. Roddick, Mr. C. Heath, Dr° Mitchell Banks and Dr. Saundb3^ The chairman, in proposing the toast of the evening, presented Lord Lister with the following adilress : — fl I/ni- n thr Jtion |er by dele- ^aris, Con- |fc and le b\ lation e has life- two f the new ? the janic liem. dis- .silk- tion- THK lilUTISU MKCICAF. ASSOCIATION. 55 To (he RvjJit Honorable the Lord Lister. My Lokk,— Tlie members of the Montreal Me(lico-Chirur{,'ical Society rejoice in tlie opportunity utf'onled tliem of con^riituiiitinij; your LonlHliip on Imvinj; been seleoteil t)y the best Sovereign tluit ever graced a throne, for the high distinction of the (eerage. .Vo one in the ini dical profession was more worthy Tlin ugli a hing ])eriod of years you liave, through metliod.s well nigh perfect, souglit after truth with an intelligence and disccriinient given to few, with a patience and assiduity and, above all with a truthfulneNH and modesty that cannot but exert a salutary influence on all searchers for scientitic truth, and with a success utisurpassed in the history of modern medicine. These | urely sci^ ntitic researches of your earlier years were the foundation on which at a later period you built the magniticent structure of antisepsis, which places you on the scroll of fame with Harvey, Hunter, Jenner, Simpson and Pasteur. In advancing scientitic and practic*! surgery you have advanced every branch of the healing art. and by investigations which have led you to the detection of the causes of disea-e you have brought us to a knowledge of tlie hindrances to the healing process, Hfnce'orth pre- sent and future generations may point to your Lordship with pride as the man who has brought relief from sutt'ering in every (|uartor of the globe. May your years be many, and may they be filled to repletion with the happiness which is born of having done nobly and well. Lord Lister, in reply, said he was much impressed by the enthusiasm with which the toast had been received, and he should cherish the addre.ss he had been presented with as long as he lived. He thanked them deep- ly for the great honor they had conferred upon him. The real work of the meeting began on Wednesday morning, when each of the eleven .sections assembled in ihe commodious class-room of McGill University and the closely adjacent Dioce.san, Wesleyan and Presbyterian College.s. No more ideal site for a scientific congress could well be found ; and the arrangements were so excellent that no ditticully at all was e.xperi- enced in finding the location of any section. Nor should mention be omit- ted of the very excellent and abundant accommodation set apart for reading, writing, smoking and other rooms. The attendance at each of the vari- ous sections was very good ; and as will be seen from the reports, many subjects of much interest were discussed. In most sections the Presidents delivered addre-ses, some of which might even have formed a basis for discussion. Interesting and able reviews of the ri.se and progress of medi- cine, therapeutic^, pathology and deniiatolocy were then given respec- tively by Stephen Mackenzie, Dr. Leech, Mr. Watson Cheyne and Mr. Mal- colm Morris in the sections over which they presided. In the Section of Surgery, Mr. Christopher Heath, with characteristic candor, commented upon the exacting demands of pure .science upon the time of the modern student, to the neglect of the important practical training in his life-pur- suit. In the Section of Psychology a most interesting ami philosophical , study of Mental P>olution in Man was given i)y Dr. Bucke, which, we venture to think, will be widely appreciated. Amongst the subjects debated on Wednesday, that of rheumatoid arth- ritis in the Section of Medicine was shared in by a large number of speak- ers. The question was discussed mainly froirji the etiologic 1 standpoint; the views of the opener, Dr. Stewart, in support of an infective agent. 51) TIIIC MONTREAL MEETING OF beiiiy c()iiil)att'il l>y many who found more evidence in i'avor of the ner- vous origin of the disease. A tliorouijhly inaclieal and instructive deliate on the (reatnient of insomnia in the Section of Therapeutics and Phar- macoliiLry was weil sustained, there being a very gratifying unanimity in dc|iricatiM!; resort to liyimotics uidc'^s comi)elie(i. In Surgery, the topic of appendicitis aHorded scope for eliciting experiences of many surgeons, but, as was to be expected, the necessity for operative treatment in many cases was variously advocated or deprecated. In the Section of Public Medicine tl'e in)portant topic of municij)al measures in dealing with cer- tain infective diseases was discus 2d, and the remarks of Dr. Handford advocating education and persuasion rather than compulsion deserve attention. In tiie Section of Obstetrics and Gynsucology the vomiti'ig of ])regnancy evoked many valuable practical experiences, and in that of Anatomy and Piiysiolngy, the debate on tlie Teaching of Anatomy, .shared in by sucli competent authorities as Prof. Alex. Macalister, Prof. M. Foster and Dr. Sliejiiiard was animated. The paramount importance of practical woik in the dissecting room was insisted on by all; but it would have been gratifying had a like unanimity prevailed as to the haiiiifuiness of too much tutorial instruction '.i a sul»ject best learned by personal practical work. At the close of the general meeting held in the Windsor Hall on Wed- nesday afternoon, and after the vote of tliaidciission the President (Mr. Heath) read a letter from Dr. Kraske on the subject. In Public Medicine the sub- ject of (Quarantines was treated in an exhaustive manner l)y Drs. Mon- tizambert, Wynian and Duncan, and gave I'ise to an interesting debate. The Hections on Therapeutics and Dermatology held a conjoined sitting for the purpose of discussing the treatment of sypliilis, which e.xcited considerable attention. A very thoronixb view of senun diagnosis was art'orded by the debate introduced by Prof. Adami in tho Section of Patho- logy and Bacteriology; laiyngeiil paralysis was the theme in the Section of Laryngology, and that oi Anaslhetics in the Section of Anatomy and Physiology. This latter debate, introduced l_. the President, Dr. A. Walker, was of a decidedly controversial character; the results ot tho Hyderabad Commission being brought nnder notice by Col. Lawrie, 7. M.S. The Annual Dinner of the Association took place Thursday night, at the Windsor Hotel. The dining hall had been most tastefully deco- rated by Hags and banners, tlie latter bearing t.lic names of the pro- vinces of the l-)omini(in, as well as tiie initials B. M A. The President, l)r. Roddick, was su])))orted by a distinguished company, including the Governor-General, the Chief Justice, Lord Sirathcoiia and Mount Uoyal, the Mayor of Montreal, Lord Lister, Prof. Kichet, Sir William Hingston, Sir James (Jrant, Sir William Foster, the Kev. S. Barclay, Prof. Michael Foster, Mr. Wlieelhouse and many others. A b;)ut .")()() attemled the lian- (juet. The toast list was a lengthy one, and the speeches of a liigh order — one of those most appreciate! I being that given by the llev. Dr. Barclay, who with Surg. Lt.-Col. Lawrie was called upon to respond to the toast of the Army, Navy and Au.xiliary Forces. The regrettable alisence from indisposition of the Lieutenant-Governor of (.^Jueiiec deprived the com- pany of again hearing his elor|uence. A pleasing incident was the pre- .sentation of an address to Lord Lister by the members of the Medical Faculty of tlie l^niversities of Dalhousie, Halifax, to v.'hich his Lordsliip made aceful reply. i ■1 I! .V most delightful break in tho day's proceedings was enjoyed by a large party of the members of the Association and otlicrs who were en- tertained on Thursday at luncheon on the Mountain by the Mayor and Aldermen of Montreal. The day was all that could be desire as fresh and wholesome, in every respect, as on the dav it was ]iut U|). Here, also, were all the other preparations of this wondeifnl concern, all bearing the legend, " Bovril," wliich is a .synonym for only the very best and ])urest of ingredients. B ivril. Bacon Rations, Lime Juice Nodules, an excellent preventive of scurvy, etc., and will be invaluable in the Klon- dyk(!. Bovril Tablets, splendid for bicyclists, etc. Kudos Cocoa ^^ssence and Bovril Wine, made of beef and port, instead of sherry. The whole exhibit reflected a great ain incident to the diseases of the female sexual organs. A preparation which is now being introduced to the Canadian clime is anotlier of Messrs. Wyeth's under the name of Powdered Thyroid Gland, a remedy for obesity and myxodema. Its success in the United States has been very marked. It is also put up in tablet form, each tablet con- taining five grains of the thyroid gland of the sheep. In connection with Messrs. Wyeth & Brother's exhibit a very compact and handsome real seal leather hypodermic case was presented to the physicians and was much appreciated by the recipients. The J. Ellwood Lee Co., of Conshohocken, had a very extensive and bcautitul display of medicinal and surgical plasters, absorbent cotton, an- tiseptic dressings, hospital and physicians' supplies, also a full line of aseptic and cumolized ligatures comprising catgut, silk-worm gut, braid- ed and twisted silk, cable twist, etc. The two attractive young ladies who were in attendance of this section lent an additional charm to the exhibit, and the number of physicians who availed themselves the pleasure of a visit to this collection was evidence of the interest taken in Messrs. J. Ellwood Lee's goods. The style in which all their goods are put up, and the exceptional quality of all the articles, are alone a guarantee. A. noticeable thing in connection with this exhibit was that all their goods were open for inspection, and could be handled by any one, and thoroughly examined. Mr. De La Cour of the home laboratory did the honors of this section, and was indefatigable in his efforts to instruct all callers. The Fellows Medical Manufacturing Co., of New York, had a very tastefully arranged display of the Compound Syrup of Hypophosphites, and distributed several hundred samples to visiting physicians. The peculiar merits of this preparation has won for itself a world-wide reputa- tion, and it has become so favorably known throughout the world that it is prescribed in pulmonary and other diseases by the profession in every country in the world. Among the many preparations brought before the British Medical As- sociation in Montreal, much interest was shown in a new formula for a salve or ointment which is absolutely free from grease in any form, thus removing the very strong objections of Koch and Breslauer to this form of dressing, as it hindered complete contact, and absolute contact is necessary before microbian life can be destroyed. Again : Mr. W. Wat- son Cheyne has shown that some of the ointments in the pharmacopoeia are too strong if used of btandard strength in some cases,* and advises re- ducing one-ha.f, or even one-quarter. It appears as if the lack of benefit from the use of ointments has been owing to causes o:,ly recently understood, and hence their disfavor with many physicians. The ancients had success with ointments said to be composed of some of the ingredients in the formula given us for styraphenol ; and the re- Tide " Woiindp, Ulcers anH,"' Cheyne. THE BRITISH MEDICAL ASSOCIATION. 63 suits of some cases have been very satisfactory to those who have tried this new compound before it was given a name to prescribe it by ; and we look forward to its further trial with interest, hoping it will prove its claims as a reliable germicide, discutient and anodyne, which its formula would lead us to expect : R Balsam per uferum 5 vi " tolutanum 3 v Benzoin 3 p Styrax .. ) . Olibanum aa | rfi Colophony § ix Phenol g iii We found the vapors of this preparation decidedly pleasant and soothing, while heated in Medical Museum exhibit to demonstrate its absence of irritating properties, when inhaled for throat and lung troubles, which styra-phenol claims to benefit. APENTA. Close to Bovril was a very fine exhibit of Apenta Water, made by the celebrated Appolinaris Co'y, and being in charge of Mr. Maguire. This product is a bitter water derived pure, and in a perfectly natural condi- tion, from springs situated near Budapest. It belongs to a class of pur- gative waters, but its action is of a mild and non-irritating character. Apeuta will become a favtjrite water for family medicinal use, and in many of the slight derangements of life whereof digestive troubles, bil- iousness and the like are examples, it will be found serviceable. We would particularly wish to draw the attention of the physicians and surgeons of Canada to the Lyman Bros. & Co.'s, Limited, Anesthetical Chloroform, in 1 lb. bottles, and Lyman's Anesthetical Jlther, in quarter, half and 1 lb. tins. Regarding the ether, they are continually receiving recommendations from the leading medical practitioners from the Atlantic to the Pacific, prominent among which is the following from F. W. Ross, who writes : " I have now overcome ray former prejudice against local manufac- turers of ether, and am now using Lyman Bros, & Co.'s ethar for opera- tions of all degrees of severity. The after effects are no greater than after any other pure ether." Regarding Lyman Bros. & Co.'s choloroform, which is being used by most of the leading surgeons in Canada in preference to any other make, Dr. T. G. Johnson, Mayor of Sarnia, who is the leading surgeon in West- ern Ontario, writes as follows ; " For a number of years I iiave used no other chloroform than that manufactured by Lyman Bros. & Co., both in surgical and obstetrical practice; and have had, and still have, every reason to be thoroughly satisfied with it." Again, we have the following from the late J. H. McCollum, who writes as follows as long ago as 1888: M 64 TIIK MONTUKAI- MKETINfi OF " During the nearly five years in which I held the position of medical suporintendenf of the Toronto General Hospital I administered to aljout 1,000 patients annually, and in no case had we fatality from it. It has two very strong' reconiiiiendations — first, its comparative cheapness; second, the sta;,'e of excitement is not nearly as great as with other makes." 'I'he nianufiicturers would be glad to supply a sample of either chloro- form or ether on ai)iilication from any physician or surgeon, preferably through their local druggist. There is one thing the LANCET will point out: any statement made by the Lyman Bros. Co. is thoroughly to be relied upon, and will be absolutely true. " The mannger, Mr. C. Mel). Hay, is a gentleman who is particularly well known to brth the medical profession and the entire business com- nninity of Canada, is a thoroufrhly progressive Catiadian, with extraordi- nary executive ability, which has enilearcd him to the profe.ssional and business community alike, and conseiiuently anything shipped from this well-known, responsible firm can be thoroughly •• Med upon. The house of Frederick Stearns \.' Co. was founded by Mr. Frederick Stearns, who came to Detroit in lim chicle basis. Each pastilo represents 15 grains of fresh, undried, true African Kola. 1 ()(i THE MONTRKAL MEETING OF Since the investigation of Sir William Roberts tlie use of artiHcial starch di'^estants has become very popular with the medical profession in the treatment of amylaceous dyspepsia. These preparations of diastase arc from three sources, viz. : malt, fungus, and the pancreas of the j^ii;. The latter has the advantage of being the kind of diastase which nature (lesifrned to be employed in the alimentary canal of animals. The pro- ducts formed by it differ in many respects from those resulting from the action of diastase of vegetable order, and are more nearly fitted for animal nutrition. Add to this the marvelous activity of pancreatic diastase, which when properly prepared is capable of converting all the starch con- tained in an urdinaiy meal into sugar in an instant of time, even when employed in a com]taratively small amount, and the |)hysician has in his hands a most powerful aid lo starch digestion. Frederick Stearns & Co. exhil)it pancreatic diastase both in dry and liquid form. The former is offered in '2h grain jMllo'ds as " Diasta.se- Stearns," and the latter in the form of a delicious cordial, each tea.spoouful of which contains two grains of this active d.gestive ferment. Of late years there has been a large demand for the Serenoa serrulata, or Saw Palmetto, as a genito-urinary tonic, a drug from Southern United States. Its virtues were discovered by Dr. J. B. Read, whose introduc- tory article appeared in the American Journal of Phartnacy for April, 1879. Since that time the drug has grown in reputation as a sexual tonic, sedative, diuretic, expectorant, and remedy for the catarrhal conditions of the mucous membranes in general. Triticum in the meantime has held its high reputation as a diuretic; free from irritating qualities, and has been much used in the treatment of chronic urinary difficulties, on ac- count of its bland and .soothing nature. The combination of two such drugs, each highly recommended for the same class of troubles, but dif- fering somewhat in method of action, yet working in harmony, naturally gives to this compound fluid extract a wider range of usefulness than either drug possesses alone. And, when the merits of the m&ny aspirants for therapeutic favor in the treatment of genito-urinary affections of a chronic nature are considered, it will be found that none other offers such advantages as their preparation. This compound fluid extract has been devised by Frederick Stearns & Co., for the convenience of physicians who may desire to prescribe fresh Saw Palmetto and Triticum in com- bination. It has the advantage over extemporaneous prescriptions in that the proportions and vehicle have been so nicely adjusted that what in thehiselves are disagreeable medicines now become agreeable and ac- ceptable to patients. This desirable result has been obtained at the cost of much experiment, so that the preparation represents more than the ordinary skill of the pharmacist. The word " Tritipalm " was coined by Frederick Stearns & Co. sis their commercial signature (not as the name of the medicinal preparation) to distinguish their brand of Compound Fluid Extract of fresh Saw Palmetto and Triticum from other brands that may afterwards appear on the market. A beautiful line of filled capsules without air, known as " Capsoids," also forms one of the attractive specialties, which, on account of their pharmaceutical elegance and the handsome packages in which they are THE BRITISH MEDICAL ASSOCIATION. 67 displayed, offer a form of medication pleasant to the eye and aji;reeable to the patient. There are more than tifteen drugs and compounds exhibited in this form, such as Apiol, chlorodyne, copaiba, creosote, cubebs, etc. Another line which has become a leading specialty with the house is that form of wafer known as the " Cachet." Probably this is the best of all forms for dispensing powders on account of the ease with which the little envelopes are swallowed. Frederick Stearns & Co. have distinguished themselves as manufacturers of sugar and gelatine-coated pills, fluid ex- tracts, and other standaril pharmaceuticals which, together with their specialties, form a most comprehensive list. Add to this their publication department with its scientific monographs, valuable conmiercial litera- ture, and its two periodical publications. The Nrw Idett, published as the organ of the house, and TJie Phurmacologisf , published by Mr. F. K. Stearns, personally, aided by a corps of physicians and pharmacists well known in their respective professions, and we have in the house of Fred- erick Stearns & Co. an example of American pharmacy well worthy of emulation. Messrs. Parke, Davis k, Co., of Walkerville, Ontario (Home Offices and Laboratories, Detroit, Michigan, with branches and distributing depots throughout the world), occupied a very prominent position in the Annual Museum in connection with the British Medical As.sociation meeting in Montreal. The Museum catalogue shows their location as comprising Sections 7, 8 and 9. These sections were very neatly grouped together under a mas- sive oak canopy, the drapery and decorations being specially arranged by Beulac, the well-known decorator of Montreal, while Martin, the florist, furnished the palms and other plants. A cluster of Auer lights in the centre of the canopy materially added to the appearance of the exhibit, enabling physicians more readily to examine the various disease germs and serum products displayed by this House. We learn on enquiry that they now have the most extensive plant for the manufacture of Biological products in America, and, in keen competi- tion with certain State-subsidized Health Boards, who also manufacture serum products in the United States, have recently secured contracts from several of the large.«it users solely on the merits of their product. One feature which commends itself to the careful physician is the man- ner in which their Antitoxic serums are marketed, viz., in hermetically- sealed bulbs, the dose being adjusted entirely' by units, irrespective of the quantity of serum employed. Parke, Davis & Co.'s exhibit — a strictly scientific one — appeared to be the central rallying point of the various physicians who visited the Mu- seum, and everyone seemed to appreciate not only the display made, but the courteous treatment accorded them by the representatives in attend- ance. In addition to a most elaborate cjise of disea-se germs. Diphtheria Anti- toxin and the various other serums prepared by this well-known firm, were to be found Culture Media tubes intended for hospital and private practice ; Nuclein Solution 6^ for hypodermatic or oral administration ; 68 THE MONTUEAL MEETIM; OF Germicidal Soap (McClintock formula) ; Serum and Hypodermatic Sy- ringes, a late innovation heinj,' an improvement in antiseptic needles — Schimmel's patent. In another section was shown Oolden Seal and its various products in the form of Huid extracts, powdered extracts, solid extracts, concentrations, alkaloids and other compounds ; their justly cele- brated Taka- Diastase, and a most convincinvd Pans, Urinals. The Alpha Patent Atomizer, the special fea- ture of wliii-h is the tube connecting the bulb with the hard rubber spray. It is .so constructed as to expand and contract. On this account it forms a .sflf-aeting expelling reservoir which forces its sup])ly of air forward into till' spray. With the Alpha Atomizer an absoluuly continuous spray is produced with a minimum of fatigue to the hand. The Alpha ( 'atlieter, with the depressed eye, will recommend itself to the profes.sion. The material of which it is tnade is guaranteed not to swell or decompo.se in uiine. H. K WAMPOLE & CO. H. K. Wampole iV Co. (Philadelphia, Pa.) had an exhibit arranged in a most attractive maniKU- in a richly carved oak canopy, in the main aisle near the rear of the building, Imt notwithstanding the fact that it was somewhat removed from the door, there was always a crowd of physicians diinking in the words of wisdom as they tioweil from this firm's popular Toronto representative. The preparations shown were: Wampole's Taste- less Cod Liver Oil, whicli is a solution of the combined alkaloid and other active meificinal principles of cod liver oil, all the oily or fatty portion being eliminated. Then on the .shelves were arranged Compound Syrup of White Pine, Syr. Hy«;^^ ^ J- 1 ypewriter Is used and endorsed by all the leading; ^ members of the medical profession ^ throughout the world *i Send for pa'-ticulars of special medical ^ key t -rd. ^ Edison's IVlinieograph |^ u u J I o J y Duplicate* many copies from one original. Particular* cff New lyjOdelS O at\a 7. ,„d sample ol work on application. T^ Of i) A UU U MONTREAL and TOHONTO ^ OpEClQTian O^ rirCnDOiU; Largest Typewriter Dealers In Canada ^J 74 THE MONTKEAL MEETING OF The CANADA LANCET ^ jt HAS THE ^ ^ LARGEST CIRCULATION j« ^ OF ANY ^ ^ MEDICAL JOURNAL IN CANADA. 3< 3C THE BRITISH MEinCAI. ASSOCIArifiN IX ^ A FFADA QUEEN ^ or 3a1 I \JjMJ radiators 20PATTERNS NO BOLTS NO PACKING THE TORONTO RADIATOR Mrc f2Qvn> TORONTO OTSIT THE MONTREAL MEETING OF Announcement. » > ♦ < ♦ ft is now 18 years since Professor E. B. Shuttleworth commenced to manufacture Fluid Extracts, Phar- maceutical Preparations and Specialties. During this time his products have grown in favor with the Medical Profession and Druggists throughout Canada. For the purpose of further ejctending the line this Company was organized, and incorporated during the prtsseyvt year, Prof, E. P. Shuttleworth has fully iden- tified himself witli it, and all future additions to this catalos'ue will have his endorsation. The preparations of this Company are produced to meet the requirements of the hindredprofessions of Medi- cine and Pharrnacy, and one of the conditions of Prof. E. B. Shtittleworth' s connection with the Company is that its manufactures shall be entirely restricted to compounds prescribed by physicians. Our policy will be to keep pace with modern Pharmacy , and manufacture preparations of an exact and uniform character which may, with perfect confidence, he accepted by the Medical Profession as being in all respects of standard quality and strength. The revised Price List gives a general idea of the lines manufactured by us, and the range of prices at which they are sold. Variations from the quoted prices will depend upon the quantity ordered. NEVi o Dl ^^' E. B. Shuttleworth Ghernical Cornpany, Limited. E. B. SHUTTLEWORTH, Pl,ar. D., F.C.S., President. H. W. AIKINS, r^.D., Vice-President. W. A. HOWELL, Sec.-Treas. CEO. W. PARSOHS, Manager. Send fop oar Catalogue Containing: the Most Recent Fopn-ulaa. For THE BRITISH MEDICAL ASSOCIATION. XI NEW HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM. DH. MEYERS (M.R.C.S. E.-ig., L.E.C.P., Lond. ) +<-' Ail Kinds of Brass and Iron Bedsteads Suitable for hospitals, Sanitariuns, Etc. ^>+<-^ The B. M. 'sr„rr Mattresses Illustrated Catalogue on Application. THE URITISH MEDICAL ASSOCIATION. Xlll .^Thc Ball Nozzle Syringe dit'tuses a soft, gentle, conical- shaped film of water, reaching m'cry part oj the vaginal cavity, cicansinjf thorouf:^hly the mouth and neck of the womb ^ and the cul-de-sac, and remov- ing therefrom every particle of foreign matter, the presence of which is the cause of disease, pain and suffering, its effect is one of gentle bathing, or spraying, rather than one of percussion, such as follows the application of a solid straight stream. This absence of force is absolutely necessary in ap- plications to sensitive organs. The stream is curved in every direction, and is a hollow stream ; it is therefore impos- sible for it to enter a practically straight canal such as the uterine canal. C. The Ball Nozzle Syringe ^ S> Accomplishes Wonders for the Health of Women. Endorsed by the Highest Medical Authorities. . . SETID FOR PRIVATE CIRCULAR. MANUFACTURED BY Th- Ball Nozzle Co. '^"''*'' Confederation Life Building, cf^H' TORONTO XIV THE MONTREAL MEETINO OK ^ I PERSONAL HYGIENE I Wampole's Antiseptic Solution g ^ (FORMOLID) ^ A very superior and concentrated preparation A Non-toxic Antiseptic and Germicide Absolutely Safe, Internally and Externally NON-IRRITANT PROPHYLACTIC /^/^^^^^•^y^y^/^•^•^^', \ i per ct. COMPOSITION Formaldelndc .... Acetanilid ..... Boroglyceride .... Sodium lienzo-Horato ... Eiicalyptol, Thymol Menthol, Ol. Claultheria Alcohol, Witch Hazel nouth Wash, Oargle, Douche. A General Healing Antiseptic for Wounds, Cuts, Bruises, Etc., Etc. ^ ^ ({etail Price FIFTY CENTS for a full sixteen-ounce bottle. Special Price in j£ bulk for Dispensing, Hospitals, Etc. Trade size at Druggists. ^ SAMPLES for trial sent free of cost upon application to us. ' ^ PREPARED BY i p I HENRY K. WAMPOLE & CO. I Manufacturing: Pharmacists PHILADELPHIA, PA., U.S.A. THE BKITISH MEDICAL ASSOCIATION. XV Chloroform and Pure. Lyman's S.Q. i.49- Ether Sulphuric Pure. Lyman's S.Q. 0.735. For A naesthetical Purposes. (The above have beei\ n^anufactured by our flrn^ for over forty years, and are being used by leading Surgeotis and Physicians in Canada.) Tho late Dr. J. M. AlcCollum saiil of our Chloroform, "ihal iluriiijj tlu' noarly five yi-ars that I held the position of Mecliial SuperinltMiilonl of tho Tnronlo GenernI llospitiil, the Chloro- form inaiuifactiired by The Lyman Bros. & Co.« Limited, whs adminislereil to about one ///o;/A'(i«rf amiually, atid in no i-ase hail we fatality from it. / Imve also iisiui it for thirteen years in private praetiee." Dr. T. 0. Johnson, Sarnia, say>i : " For the last six or seven years I have used no other Chloroform than that inamifattured by The Lyman Bros. & Co., Limited, both in sur^neal and obstetric.Tl practice, and have had, .md still have, every reasoti to be thoroujjhly satisfied with it." We Claim the Following Advantages 1st. Its Compapattve Cheapness. 2nd. The Stag^e of Excitement Is not Nearly as ' '-peat as with Othep Makes. 3pd. The Aitep-EfTeots ape not so Pponounced. 4th. No Offensive Odop Duplnsr Admlnlstpatlon. D. C. O'Reilly, Medical Superintendent of the Toronto General Hospital, says of our Ktlier Sulphuric : " During the last several years the Ether manufactured by The Lyman BroS. & Co., Limited, has been extensively used for ana.'sthetical purposes in Toronto General Hospital, and no accident has taken place from its administration." Dr. James F. W. Rosa says : " I have overcome my 'I'ormer [Prejudice against Ether, buf The Lyman Bros. & Co., Limited, are now supplying- an article put up in % and '/j lb. tins equal to any in the market. I have used it frequently, and have seen it used by others during the last twelve months for operations of .ill degrees of severity. The after-eifecis are no greater than after Squibb's or any other pure Ether." ^ We claim for this Absolute Purity and G>mparative Cheapness. \Vhen Opdepln? Specify LYMAN BROS. '\ '"' LYMAN BROS. & CO., LIMITED, - TORONTO. .1 IMAGE EVALUATION TEST TARGET (MT-3) A .V4 ■■?o 1 r / ^ 1.0 I.I 1^12.8 150 *^" ^ m Ui 140 u 11.25 12.5 22 12.0 1.8 U 111.6 V] <^ / ol r 7 '^> %^ ^^ '/ Photographic Sciences Coiporation 23 ^fST MAIN STREET WeBSTER.N.Y. Mli60 (716)172-4503 "V^^ V i^ ^/ I. m V'i^' XVI THE MONTREAL MEETING OF O'KEEFFS ^. Extract Of. MALT ^ Briti ja;S!^<^^^ ^Op. ^^^^^© Carefully prepared from the best Canadian Barley Malt, and Eng- lish and Bohemian Hops* ♦ ♦ ♦ * Containing no Foreign Matter. Lowest Possible Percentage of Alcohol i All parttculars will be gladly sent to any physician addressing : W. LLOYD WOOD, Wholesale Druggist, Toronto. wm^mimm^ British America Assurance Company Inoorpopated 1888. HeadOff i ce . . . ♦ J^QRONTO, O^^' Losses Paid Since Orgar^ization, $16,067,722.56 o,REcroRATE= J J. KENNY. HON. OBO. A. COX, vic-ProWnt .n4 M.n.gln« Wr^or. Pre.W«nt. ^^^j^ HOSKIN, Q.C, LL.D.. HON. S. C. WOOD, ROBERT JAFFUAV, S. F. McKlNNON, AUGUSTUS MYERS. THOMAS LONG. ^ ^ PELLA'I r. / / '^ Every Retail Pharmacy is a Depot for Our /^*. , Serums. "" 1 If your druggitU has not the Antitoxin on band, it can be wired for to our Laboratory in Walkerville, or to the following firms who receive fresh supplies weekly: THE S. B. CHANDLEK, SON & CO., (Limited), = Toronto. MESSRS. LYMAN, KNOX & CO., = Toronto. ^ THE LYMAN BROS. & CO., (Limited), • = Toronto. MESSRS. ARCHDALE, WILSON & CO., = - Hamilton. MESSRS. J. WINER & CO., = = = = Hamilton. MESSRS KERRY. WATSON & CO., - = London. MESSRS. J. A. KENNEDY & CO., - - = London. l1[RM[TICAIiY Sealed 4 ti "As to the antitoxin to use, having tried five or six different makes in the past two years, I have found that manufactured by Parke, Davis & Co. most efficacious. Apart from the potency of thi." brand, I must commend the ingenious manner in which it is marketed, viz., in hermetically-sealed glass bulbs, which exclude the air and keep the serum strictly aseptic." — Dr. Geo. Duffield, in the Journal of the American Medical Association, March 6th, 1897, page 446. . •>i '^::V:, ■j;-: ''•i-ii.ifi ! ,,;■> "W'r^i^j^ ,•,..'1/.