From Worcester Dr. Baudouin proceeded to Boston. Of this city he says: "It would be supposed that at Boston, the Athens, or, better, the Edinburgh of the United States, the most cultivated city beyond the seas, the schools of medicine would be superior to those of the rival cities of New York and Philadelphia. It is not so, except, perhaps, the Harvard Medical School. But this school, which ranks first in Massachusetts, and which is situated in Boston, while the other buildings of the University are at Cambridge, a suburb of Boston, is hardly larger or more celebrated than those of the University of Pennsylvania or of Columbia College."

Dr. Baudouin's notes on Harvard University as a whole are exceedingly meager. Of the medical school he says: "This chief medical school of Boston, although a part of Harvard University, is situated in the city. The buildings occupy an entire block on Boylston street, not far from the Boston Athletic Club, one of the famous clubs of Boston, the great public library, and the Public Gardens, where the statue of carved bronze in honor of the discoverer of anesthesia by ether is erected. The massive structure of red bricks presents an imposing but severe appearance.

"The course of study at this school has within a few years been changed from three to four years, and is extremely rigid. The course also has been recently extended; anatomy, physiology, embryology, bacteriology, and hygiene, concurrently with general and medical chemistry, form the subjects of the first year. Unfortunately the entrance examination is not very severe, not at all comparable to our baccalaureate's. It is the same everywhere; the students of the learned professions in America are not, as with us, taken from the cultivated classes; and the doctors commence their special studies very poorly equipped in point of general instruction. "The school is equipped with laboratories for bacteriology and special rooms for experimental work in histology, physiology, chemistry, etc.

"I noticed at Harvard University, as elsewhere, that medical physics is not well developed, at least not in comparison with chemistry. The courses in natural history also are very limited. They give much less time to zoology and botany than we do. Perhaps this is due to the fact that the students are supposed to be sufficiently advanced in these studies when they enter the medical school. Clinical studies are pursued in the several hospitals of the city, which afford great facilities for this work. A sort of post-graduate course has been instituted in connection with the regular school, analogous to those in New York. It comprises a very important personnel, whose members lecture in the various city hospitals to doctors wishing to perfect themselves in one or the other branches of the healing art."

M. Baudouin describes at length the Harvard school of dentistry and speaks of its wide reputation. He devotes nearly a page to the veterinary school, and in closing says: "The instruction here is very complete. Ophthalmology is taught in a special manner, and of course there are chairs of anatomy, botany, of chemistry, general and medical, of pathological anatomy, etc. The course of study is for three years and is based upon the usual curriculum of the medical schools of the country. The practical work is organized with care. The Massachusetts State board of cattle commissioners and the board of health of Boston have some official connection with the school, which is also of practical advantage to the pupils. The veterinary hospital, founded in 1883, affords the pupils opportunity for clinic exercises."

INSTITUTE OF TECHNOLOGY.

"It would be unpardonable," says our author, "if in my enumeration of the scientific institutes of Boston I should forget its famous school of technology, well known to the pupils of our schools of arts and technical professions. It has a special section of biology for sanitary engineers. This magnificent establishment which represents exactly our École Centrale, has superb laboratories of chemistry, physics, etc. I only regret that I can not describe them here."

HOSPITALS.

The numerous hospitals of Boston are enumerated in the report, and a few described in detail. Of the Massachusetts General Hospital Dr. Baudouin says: "It is old, but has yet a certain interest on account of its dimensions, and the new buildings which are contemplated. An operating room is to be added, which will be in conformity with the most modern ideas.

"The Boston City Hospital, of more recent date, does honor to the city which has founded it. I must mention particularly its tent service, that deserves detailed description; its capacity-it is one of the largest, after Bellevue Hospital, in the United States; and the nurse training school which is attached to it.

"Before leaving Boston one should visit the McLean Hospital, an annex of the Massachusetts Hospital. It is a vast hospital asylum of recent construction, built at Waverley, a few miles northwest of Boston, not far from Watertown and Waltham,

1 The regulations recently adopted will require a literary degree for entrance.

It is composed of a number of buildings erected in a beautiful park in the midst of a grove of old oaks. There are six buildings reserved for the sick. In the center of this group is the administration building, which contains the offices, the library, the telephone, a dispensary, etc., in the first story, while the second and third are occupied by the personnel of the hospital. At a certain distance are found other constructions remarkable for their arrangement: Upham Memorial Building, formen; Appleton Building, for women; Belknap House, containing numerous rooms well arranged, with refectories, halls, etc. Each of these buildings is independent of the others, and all are heated by steam. A training school for nurses has been annexed to the McLean Hospital since 1882. I will here say a few words concerning it, for I have had scarcely an occasion to speak in detail of these schools which are so common in the United States:

"The training school at McLean, like others of the same character, is under the direction of a woman superintendent, subordinate to the superintendent or director of the hospital. The lectures of elementary instruction are delivered by the chief nurses and supervisors and technical lectures by the doctors and surgeons of the hospital and their assistants. From time to time the pupils pass examinations. Naturally they are instructed in all that relates to the service of the sick room, to simple dressings, and the first principles of massage and the necessary preparation for slight surgical operations. They are taught to recognize the chief symptoms of disease (delirium, coma, etc.); they learn how to restore asphyxiated patients; they are shown the necessity of thorough disinfection, and, above all, the benefits of constant and thorough cleanliness.

"In return for this instruction they give their services to the hospital. They live at the hospital in the capacity of nurses and assistant nurses, and receive only sufficient money to pay for their clothing. The women receive $12 a month the first year and $15 the second year. The men receive $23 the first year and $25 the second. The studies last for two years, and after the diplomas are granted the pupils become graduated nurses and receive appointments at $25 per month for the first year and $30 per month for the second year. The men are a little better paid; they receive $27 a month the first year and $30 a month the second year. At least these are the salaries given at the McLean Hospital. In other cities they are higher.

"It is needless to remark on the suggestiveness of the comparison of the salaries received by these nurses and those of Paris. But I ought to add at once that the personnel of the American hospitals in point of morality and intellect surpasses that of our hospitals. The nurses, in the great cities of the East especially, are for the most part women above the average. This is so true and is so well recognized that many of them, well raised, pretty, and well educated, marry the medical students. The system of marriage dowry does not exist in the true Yankee family. Apartments as luxurious and well furnished as those of the assistant doctors are reserved for these nurses. It is certainly true that women generally are better cared for in America than in Europe, and that on the American side of the Atlantic the comforts of life are met almost everywhere, as well in the family of the simple workman as in that of the millionaire."

CORNELL UNIVERSITY.

The reputation which Cornell University enjoys in Europe made it a special center of interest to Dr. Baudouin. "The wild and picturesque region of Ithaca, in the State of New York, where this magnificent institution has been erected, is reached after a fatiguing journey, especially so to one not used to American railroads. Leaving Syracuse, a great center of commerce and manufacture of all sorts, I accomplished this interesting excursion to Ithaca in one day, and visited the campus of Cornell University in company with Mr. Fr. C. Crane, professor of the literature of the romance languages, and a sincere friend of France. Besides its college, very renowned in America, this model establishment possesses a school of law, recently opened, and special schools of agriculture, of architecture, and of engineering. The school of mechanical and electrical engineering is one of the best in the United States, and its professors are much esteemed in Europe. Many of their works have been translated into French. There are laboratories for the study of machines and the resistance of materials, which are organized with a lavishness unknown to us in France. The arrangements of the testing shops and the hall for practical work are the most unique in the world.

"The laboratories of physiology and comparative anatomy, placed under the charge of Prof. Burt Green Wilder, are worth visiting. Mr. Wilder, who is a veritable specialist in the study of the brain of vertebrates, very courteously conducted me through his museum. The specimens which he has prepared do honor to this collection of the university. This expert anatomist showed us some very well preserved human brains-the brains of a twin foetus, the brain of a young monsterand a series of preparations illustrating the development of the human brain. Almost all these specimens are truly masterpieces of fine dissection. Many other organs

have been prepared with as much skill, particularly the different parts of the heart. Almost all of this entire museum is the work of Professor Wilder.

"In twenty years he has succeeded, with rather moderate resources, in forming a zoologic collection quite sufficient for the college of the university. In this collection are some rare animals, many of them of American origin. Recently Mr. Wilder, who is an old pupil of Agassiz, has dissected an orang-outang. He showed us the brain, a preparation of which he is very proud, for it is difficult to procure this anthropoid in America. This organ is remarkable for the folds of its circumvolutions, in particular that of Broca. Mr. Wilder has established many very interesting anatomical facts with this specimen; for example, by means of this it has been possible to demonstrate the existence of the orifice of Magendie in the orang-outang. Mr. Wilder has also the brains of criminals and of men distinguished for ability. We saw in this museum the brain of a celebrated philosopher, Chauncy Bright, which is remarkable for a well-developed connecting convolution, extending between the ascending frontal and the anterior parietal convolutions at the upper end of the fissure of Roland. There is also the curious brain of a lunatic, and one of a well-known assassin, Rullott. "Preparatory course of medicine.-If at Cornell there is no faculty of medicine, there is nevertheless a preparatory course for those of its students who desire to pursue the study of medicine. This course, which lasts two years, is very peculiar. There is nothing analagous to it in France."

Hero M. Baudouin introduces the programme of this preparatory course, with respect to which he continues: "It will be noticed that drawing and military and other physical exercises are included in the programme, and also that importance is given to the studies, which in France are called accessory sciences (i. e., chemistry, botany, physics). We remark also the mixture of courses, which in the French system belong to superior instruction (histology, anatomy, embryology, etc.), with those of the higher classes of the secondary schools in France (i. e., psychology, living languages, etc.). This mixture is very curious, and shows that in the United States there is little disposition to follow our old way, the so-called classics. In any case, it is very difficult to compare our actual organization with that of American universities. It is evident, therefore, that the question of the real equivalence between American and French diplomas is not likely to be settled at once. In America everything has been conceived in a manner so novel and unexpected to our minds, accustomed to classifications fixed, but artificial, also, in spite of their antiquity, that any comparison with what passes in Europe seems to me premature at this time. It is necessary to wait for a series of reforms which are sure to take place before many years elapse. Moreover, of what use is it to attempt the comparative study of questions set for entrance examinations or of the programmes of technical schools when the respective standards of these schools differ in different schools, and according to the patronage that each controls, the resources with which they are provided, and the number of their students? Of what use is it to compare our students in the first year of the medical course, or those possessed of the diploma of bachelor of sciences limited, with the young men who follow the preparatory course in medicine at Cornell? I am satisfied that this would be a sterile work. It is important rather to consider the attractive independence and great variety of the American programmes, tho practical spirit which characterizes them. Certainly these tendencies are not indulged without great inconveniences, without some risk even to science itself. But if there are not many schools of savants in the United States, there are certainly numerous men of science, endowed with the sacred fire, and thanks to their remarkable energy and indomitable activity, America is still able to make a good figure in the world of high intellectual culture. I have already said that Johns Hopkins and Clark universities prove this. I add that at Cornell there are also a certain number of professors who belong to the phalanx of the élite."

The following extracts from the pages devoted to the institutions of the North Central and the Pacific States will suffice to indicate the extent and variety of Dr. Baudouin's studies in the department of professional instruction which was the object of his mission.

MICHIGAN.

"Ann Arbor even more than New Haven is the typical university city of America, like Montpellier in France, or Göttingen in Germany. It is nothing aside from the great number of both sexes who make the university one of the most important of the United States. Here those who wish to study the functions of high schools and colleges, the system of coeducation and the effects of common school education ought to come and remain several weeks of the school year. Life here is very quiet and

1 Burt G. Wilder. "The metapore or foramen of Magendie, in man and in the orang-outang," in American Neurological Association. (Congress of July 25-27, 1893, at Long Branch.)

the American professors and students live together in an inexpensive way very much like the Germans.

"At first view Ann Arbor seems to offer nothing very interesting to the visitor, but on closer acquaintance he discovers that it would be a great mistake to neglect the university. It really presents a curious phenomenon, very characteristic of the country, namely, the maintenance in the same State university, of two schools of medicine, allopathic (regular) and homeopathic. The allopathic school resembles those that I have already described but by force of circumstances displays a more tolerant spirit. The professors of these two institutions often mingle amicably in official meetings as they form part of the same household. This is certainly a feature almost unique in the world (to use a favorite expression of my host). It is in any case a very rare spectacle to find thus side by side the two hostile sisters. To see on the same campus the two rival establishments and to study their reciprocal relations, have certainly been special points of interest in my medical journeyings in the United States. As I have said, there are in America a great many homeopathic schools, but this is the first instance in which I have found in the same university these professors united with those of the classic schools and living thus harmoniously, Ann Arbor has also a school of pharmacy and a school of dentistry of high renown."

In describing the regular school of medicine at Ann Arbor, Dr. Baudouin notes that women are admitted, and adds: "Singular contradiction in this university where, as M. P. de Coubertin says, 'the women students have the deliberate manner, the sceptical air, and the abominable sang-froid of the Russian Nihilists,' they have not the right to dissect with the men. They also read the anatomical works in separate halls. Note, however, by the side of this a peculiarty not less interesting, they go to the hospital with the young men and attend all the clinics with them." "At Ann Arbor, the State university, instruction is almost gratuitous. The students of the school of medicine, natives of Michigan, pay $35 for the course, including entrance fees and annual dues; the other students pay $60; there are also supplementary expenses for all (diploma, $10; dissection, $20; laboratories, $76), without counting the expense of special courses. I saw on the campus the modest buildings appropriated to this school of medicine. They are not luxurious like those of the universities founded by private individuals; so true it is that always and everywhere official assistance paralyzes the generosity of individuals. I believed myself transported into one of our little secondary schools. Nevertheless, in 1892, Ann Arbor had 314 students in the regular school of medicine, without counting 63 in the homeopathic school. Apparently the number of students in the regular school is not increasing, at least the official figures show a decrease from 1880 to 1890. In the latter year the course of study was raised from three to four years; since 1890, however, the number of students has increased slightly."

MEDICINE AT THE WORLD'S FAIR.

"One word now of the great Columbian Exposition, and also of the great hospital of the World's Fair. I have had the opportunity of examining sections least accessible to the public, especially in the Palace of Homeopathy, the Children's Building, and more particularly in the Columbian Emergency Hospital, which may certainly serve as a model for our future exposition of 1900. This description, in years to come, may have a certain historic.interest when nothing of the World's Fair remains. The Columbian Emergency Hospital is situated opposite one of the principal entrances to the Fair. The building has two rooms, each containing ten beds. One room is devoted to the treatment of the sick, and the other to the victims of accidents. There is still a third room, quite large, which is reserved for obstetric cases. It contains three beds.

"The hospital is well lighted by electricity. The parts reserved for the superintendent and employees and the head nurse are furnished with luxury and taste. As in all American hospitals, flowers abound, especially in the waiting room.

"The hospital was one of the first buildings completed, and was early called into use for the workmen employed on the buildings of the Exposition. It continues to be of the greatest service, thanks to the system of ambulances stationed at each corner of Jackson Park. The surgical service, in particular, is admirably arranged. This ward is remarkable for its cleanliness, and the operating room is a veritable model of aseptic appliances. It is sufficiently large, well lighted, completely furnished, and well kept. I have witnessed here many small operations, such as in our hospitals are performed at consultations. I was told that whenever they had a serions case the patient was removed to a city hospital, but, considering the perfect appointments of the Emergency Hospital, the operation could have been as well performed there.

It is the same at Minneapolis, Minn., and in Iowa.

"On days when the crowd was the greatest there were naturally many accidents, especially from fires, which were very frequent. The Fourth of July, the national holiday, the visitors numbered less than 200,000; there were nevertheless 170 persons brought to the hospital. If, as the administration confidently expected, there had been each day from 500,000 to 600,000 persons, it will be readily seen that the hospital accommodations would scarcely have sufficed.

"Every morning the patients not yet cured are taken to a city hospital and thus at the beginning of each day the 23 beds are almost always empty. It is hardly necessary to dwell on the efficiency of the assistants at the hospital. Here are to be seen strong, vigorous women, members of the worthy body of American nurses. Two doctors are in charge; they have as aids five house surgeons very expert (I have seen them at work), two sanitary inspectors, a superintendent of the ambulance corps, very efficient, a druggist, employees of the office, a superintendent of the nurses, and five graduate nurses.

"The Homeopathic Hospital.-Not far from the hospital of the regular school is the headquarters of homeopathy. It has two parts-a small homeopathic hospital in the second story and the homeopathic exhibit on the ground floor. The homeopaths insisted upon having their hospital at the World's Fair on the same footing as the regulars.

"The model Homeopathic Hospital comprises several rooms furnished for the sick. It has a doctor in charge and many nurses. I must add, however, that I saw no sick people there.

"In the part devoted to the exhibit there are rooms for the display of chemical and pharmaceutical products and a series of framed photographs showing the Chicago Homeopathic College and Free Dispensary, the professors of the college and their pupils. There are portraits of 74 homeopathic doctors. Elsewhere they show the plans of another homeopathic hospital which will soon be erected at the corner of York street and Hermitage avenue. Dr. Streeter also shows photographs of his private hospital on Calumet avenue, devoted exclusively to the treatment of women. It is very well arranged and has in connection with it a school for nurses."

CHILDREN'S BUILDING.

"I must note in brief the Children's Building or 'Pavillon des enfants,' situated not far from the principal entrance. It contains, first, exhibits referring to infancy; second, a model gymnasium; third, a series of class rooms; fourth, a refuge; fifth, a crèche of which I will speak later. The roof serves as a court of recreation for the children and has a toboggan slide. In the crèche they care for babies during the day while the fathers and mothers visit the Exposition, or, if they are employed there, while they attend to their work. In a large room some of the little ones play together freely; others are in cradles suspended from the ceiling like hammocks and rocked by the older girls. Others occupy dainty little beds of iron, while the youngest are in the charge of nurses. Strangers at Chicago often laugh about this crèche. They can not suppress a smile at seeing the babies 'checked' on their entrance. To each mother leaving her child, a copper tag is given bearing a number corresponding to one which is attached to the neck of the child. A 'check' is used in America in place of the bulletin de bagages' with us. In spite of the pleasantries to which it has given rise this crèche seems to me to fill a need and I shall be happy to see an institution of this kind at the next exposition in Paris (1900). How many poor families might pass several days at the Exposition if they knew they would find there a crèche and competent, trustworthy women to whom they might confide their children instead of taking them into the crowd to be lost."

RELIEF STATIONS AT THE WORLD'S FAIR.

"These posts, placed at different points of the Exposition, seem to me very interesting. There are three principal stations besides the one annexed to the hospital. These flying hospitals are organized like fire companies. Instead of firemen they are in charge of ambulanciers, well trained in the duties of their office. Near a little table stands the ambulance, patiently waiting the sound of an electric bell which announces an accident. The shafts are always ready for the horse with the harness suspended over them. Behind, in a box stall, stands the trained horse; at the sound of the bell the men throw themselves into the ambulance, the doors of the box open, and the horse places himself under the harness. In less than a minute the carriage is en route. Notice of accidents is given at each end of these stations in a very simple way. There are at the Exposition a large number of alarm boxes communicating with the ambulance posts, the fire engines, and the police stations. An accident occurs-immediately the policeman nearest the scene of accident goes to the nearest alarm box, and presses the electric button which notifies the central office. From this office the proper ambulance is called and sent to the scene of the accident, the wounded person is immediately conveyed to the hospital, where an assistant,