VJMS.CC^j Hedical Observations Abroa AN ADDRES 'J INL.L -. ;3MEo;oUr- DELIVERED AT THE H VHNEMANN MEDICAL COLLEGE AND HOS- PITAL OF CHICAGO, ON INVITATION OF THE Hahnemann Medical Institute, December 19, 1878, O. H. VILAS, ZMI.A.., Is/L.ID. Printed bt Request. CHICAGO: The United States Medical, Investigator Print. 1879. t ►gC+-@SXS>-H--l£§4 Ladies and Gentlemen: In response to your cordial invitation I have appeared here this evening to speak of my medical observations abroad, during a recent extended examination of European hospitals and health resorts. From the kind reception you have given me, I augur a lenient judgment of my response,'and beg to thank you for the invitation with which you have honored me. It is indeed a task to crowd into an hour's address the thoughts and recollections which come rushing through one's memory after a stay of several months in foreign lands. And as first of all I glance along back and see face after face come into view, I now seem to remember them as old acquaintances, dear from their many time-crowded acts of genuine kindness, rather than as those whose names were only known by the fame*of their scientific works. I pause then on the threshold to.again recall with grateful recollection, the welcome extended a stranger, who found his professional colleagues ever ready to extend all courtesies, but for which his trip would indeed have been shorn of its pleasure and barren of results. I purpose in my hasty talk to glance at the subjects under different heads, and assuming that your interest will be immediate, consider at once the hospitals and their various adjuncts, colleges, dispensaries, etc. Pass quickly with me then to the greatest of all modern cities, and we enter St. Thomas' Hospital, London, and traversing the stately halls, are seated in the governors' room to hear the opening address of the winter's course of lectures. The learned professor rises to deliver the address, but a storm of cat- calls and hoots, with which we are already familiar in the highest class places of amusement, and which I was assured are a part of the Englishman's dearest privileges, compels him to desist. He again 4 MEDICAL OBSERVATIONS ABROAD. commences, but is again warned by similar cries to stop. The dean of the faculty appeals to the good sense of the students to listen, but in a low voice an honorable governor, who has kindly given me a seat next him, tells me it has been found necessary to give up open- ing addresses at nearly all the hospitals. The students are deaf to all appeals, however, and we go out with only fragments of the address Along the great halls we wander, and are told that the total cost of the buildings was $2,500,000; that they are seven in number, detached, yet connected by a corridor, are built of red brick, four stories high, 125 feet apart, and were formally opened in June 1871. Similarly we learn that its annual income is about $200,000; its capacity 608 beds, and that it receives about 6000 in- and 64,000 out-patients a year. In its faculty we discern familiar faces and recognize well-known names. St. Bartholomew's Hospital in Smithfield, the oldest in London, was founded in 1547, though dating as far back as 1102. It contains 676 beds in constant occupation, about 130 nurses, and treats about 6000 in-patients a year. 700 gallons of cod-liver oil, nearly 800 pounds of castor-oil, twelve hundred weight of salts, and from 1200 to as high as 30,000, leeches have been used in a year. We have no doubt it is thoroughly " regular " in its practice, but are more interested in recall- ing that Harvey, the discoverer of the circulation of the blood, was a long time physician to this hospital, and that the Pitcairns and Aber- nethy once lectured here. We quickly turn to Great Ormond street to see the contrast, and enter the well-appointed wards of the London Homoeopathic Hospital. We find an excellent institution, and a well-appointed room for lec- tures, and we see the names of many of our best-known men as lecturers. The school attached to this hospital is designed to be sup- plementary to courses of instruction elsewhere previously taken, and does not teach the elementary and fundamental branches. And so day after day we may pass slowly and patiently among the various hospitals, nearly always spending the forenoon at the Royal London Ophthalmic Hospital, commonly known as the Moorfields' Eye Hospital, a grand charity, the largest eye clinic in the world, and for advantages to the advanced student or practitioner unexcelled, if equalled, by any. We see the Guy's Hospital, world-renowned; the Bethlehem, for the insane: St. George's, where John Hunter died : Chelsea, Greenwich, King's Cross, and others; and simply remarking that several hundreds of similar charities, but smaller size, are known MEDICAL OBSERVATIONS ABROAD. 5 to exist, we pass to Edinburgh, rival seat of learning, and there briefly glance at its magnificently built institutions. Foremost stands George Heriot's Hospital (celebrated by Scott, in the " Fortunes of Nigel") and the new city hospital now in process of completion. Both are fine structures, and like everything built at Edinburgh, well built. Dublin, Cork, Liverpool, Glasgow, Manchester, Nottingham, and Leicester (where the British Congress of Homoeopathy met this year —a fine body) are all well provided with not only general but special hospitals, each of which is worthy of special attention. In Liver- pool especially, and Birmingham, are Homoeopathic dispensaries worthy of all commendation. Reluctantly we leave London by swift train, and soon are over the dreaded channel, and in Paris. Paris, the goal of most Americans' ideas of pleasure, gay, giddy Paris, the scene of so much that is good and beautiful, and whose by- ways rival the world in crime, has indeed need of the magnificent hos- pitals which grace her splendid streets. We stand before the great Hotel Dieu, with its imposing front and comfortable arrangements within. It is admirably arranged and the patients seem very happy. We shall have more to remember of this fine institution than any other, the steward thinks, and carrying out his thoughts I shall speak at length of French hospitals later on. We pass over this great charity, and out, pause to examine the structure, and again return for stndy. It stands on the Isle du Palais, occupying in extent the quay of the Seine from the Pont Notre Dame to the Pont d'Arcole, opposite the Notre Dame Cathedral, covers a space of nearly five and one-half acres, and cost twenty-five millions of francs ($5,000,000). It contains 514 beds, is arranged in wards, and in its great mercies and charities is appropriately named the House of God. Turning around and passing in back of the cathedral we go to the Morgue, and look in, as we often did afterwards. Cabby volunteers the remark that all Americans want to go there, but on being told that we are medical men, shrugs his shoulders and seems to think, as he intelligibly mutters, that we have a special right to such sights. Greatly over-rated from being described so often by sensational writers, I could see in it only an enlarged type of the New York morgue, in which, in years gone by, I had passed many of my happiest hours in search of pathological knowledge. Cabby thinks I stay longer than most men, and I explain to him the reason, after which he 6 MEDICAL OBSERVATIONS ABROAD. looks reflective, and hopes I will never come there in another capacity I The great Salpetriere, (so-called from having once been a saltpetre factory), perhaps next attracts most attention. It is a home for incurable or aged female patients, and the insane and nervous, but has other patients as well. It has a length of 1,680 feet, is composed of forty-five different buildings, and occupies a space of 32,542 square metres. The number of beds is 5,204, of which 2,917 were actually occupied when I was there. It is here that such excellent opportunity is afforded for the study of nervous diseases. Of Homoeopathic hospitals there are two, the San Jacques and the Hahnemann, both receptive of all maladies, and both fairly appointed. Among others, we note the Hopital de la Pitie, 727 beds; de la Charite, 504 beds; Beaujon, 417 beds, and many others. The most carefully compiled figures show the number of beds in all to be about 20,000. It is the rarest exception that they are not well kept and exceedingly comfortable. The Vienna hospital, the Allgemeines Krankenhaus, has long enjoyed a great reputation, from its valuable clinical opportunities. It is a large, regularly built hospital, with many and vast courts, and abundantly supplied with valuable cases for the student. Nowhere, I think, did I see so much care taken to instruct the elementary student, while the opportunity for advanced study under competent instruc- tors is freely open. It is a spot from which one who desires to learn, and who will be able to resist every seductive vice in its most enticing form, and openly displayed in a thoroughly immoral and beautiful city, cannot fail to profit. A fine university, to which the medical faculty is attached, has a European reputation. In this institution much of the best information is only to be gained by private class instruction. The number of students is so large, as indeed is the case in nearly all European hospitals, that individuality is only to be gained by the liberal expenditure of money. Our Homoeopathic hospital here, as well as in Brussels, to Which time prevents farther allusions, has become well known, and exceed- ingly favorably, on account of the excellent results obtained. At one time Berlin exceeded Vienna in its reputation as a medical centre. Its largest and principal hospital, the Royal Charite, intended for the poor only, has a capacity for 1,400 patients, and is much arranged as the Vienna hospital, and open to students. Other hospitals, however, are numerous, and some of the finest of eye clinics. I need hardly say that it was here that our great master MEDICAL OBSERVATIONS ABROAD. 7 in ophthalmic practise, the learned and lamented Von Graefe, won bis great and well deserved reputation. Guided by an old patient of his, I visited the scene of his former labors. It is now given over to other uses, his clinic is divided and his patients are scattered, but the fame of his name remains and has penetrated the farthest ends of the civilized world. A large and well equipped university here furnishes instruction to many students, and among them are many from our own country. Milan is a great centre of medical instruction for Italy. Its princi- pal hospital, the Ospedale Maggiore, is indeed a magnificent one, and in the number of its shops and the smell of their contents, at once recalled the familiar lines of Shaksneare : " I do remember an apothecary, And hereabouts he dwells." This magnificent structure was begun in 1457, contains nine courts, and is one of the finest hospitals in the world. Its culinary arrange- ments are extensive and complete, and one is at a loss which to most admire, the elegant building with its facade and rich window mould- ings, the finest of its kind in Milan, or the interior completeness of its arrangements. Several hundred students annually resort to it for instruction, but Italian medical and surgical art seems not to rank high abroad. Venice, the sole city of its kind, " whose carriages are boats and its . horses men," as felicitously described by an inhabitant of that most beautiful country, Ireland, lags not behind in the matter of hospitals. It has a good one, and was well filled. In Great Britain the hospitals are supported by voluntary contribu- tions- as a rule, and governed as private corporations. On the conti- nent the reverse obtains, and the government is by the state. In Paris the civil hospitals are controlled by the Administration of Public Assistance; the military hospitals by the staff of the garrison. Having now considered hastily the hospitals, we may glance at the patients, and note at once the great difference in the classes in the various countries. In none of them can we justly make a comparison with those of our own country, the ground work is so different. We live in a republic in a new land, they are the results of existing empires of a thousand years. There wealth and intelligence is the property of few comparatively, and the many neither acquire the former or seem to desire the latter. The people grow up surrounded by royalty and state, and furnished with well equipped hospitals they 8 MEDICAL OBSERVATIONS ABROAD. look forward to entering them as a matter of course when accident or disease overtakes them. Well-drawn lines of society hedge them in, and though marked instances of successful rising are occasionally somewhat ostentatiously foisted on our notice, the great mass neither rises nor seemingly aspires to do so. This we well know is not the case here. The citizen is indeed the heir apparent to the throne. All are struggling to better themselves in worldly estate, and the generation of toilers to-day is succeeded by # the thinkers and commercial men of the morrow. The greatest majority neither desire nor expect to go to the hospital; they rather look upon it as a final resort, and only seek relief there when other places are closed to them. The careless chatty Frenchman, though frugal from necessity to an extent unknown to us, spends his last centimes in the cafes chantants in gay hilarity, and accepts to-morrow's accident as an invitation to the hospital. The French have no word for " home." They have no need of it. Around that spot which clusters our dearest associations, which is the goal of our desires and ambitions, and without which would we be wretched men, the Frenchman weaves no vision of the future and has no memories of the past. He cheerfully leaves that spot in sickness to which we cling, and in other hands than those of kin, awaits the issue with a calmness that knows nothing better. The stolid Britisher toils on day by day with little to stimulate in the way of a home, as we understand it in this country. Though better off as we judge than his near neighbor, if he lives in a city, and at the best he lives on what we call crowded land, he does not expect to squander his hard-earned shillings on doctors when free treatment is at hand, but what remains from Glasgow banks he saves, and goes to the hospital. Without further illustration or comment the same may be said of all continental countries. I never knew what a life of toil and privation and beggary was, until* I had passed through Switzerland and Italy, though the hard features of Germany and Austria seemed but too severe. Two more points considered and we draw our conclusions. First, we note that the hospitals are in the midst of densely crowded • classes such as we have named, who, by the accidents of sea and land in large numbers are constant applicants for such accommodations. And second, that wealth is so accumulated in some hands that the wants and luxuries of the most lavish nature cannot expend it. MEDICAL OBSERVATIONS ABROAD. 9< Is it to be commented on unfavorably then, that their hospitals are better builded and filled than ours ? Who that is human and supplied with great means could withstand the crying poverty with which he is surrounded V Who could withstand the lashings of conscience when he reflected on the judgment to come, and hold what he had, even though the tender mercies of religion did not impel him to give ? Wealth to build and equip, and poverty to supply, will rear the grandest hospitals in the world. Having glanced at the hospitals and patients, we now are interested in the medical schools and their fruits, the medical men. Already has the learned Dublin professor's remark that he could " see no reason why women should not become medical men " seemingly been recog- nized, for the colleges and examining boards in the face of stern oppo- sition and great prejudice, have opened the way by admitting women to lectures and examination. ******* In attending on their conventions, I was especially struck by the clearness of their debates, and the sharp ringing criticisms of the papers read before their societies. All were good speakers, speaking right to the point without a useless word. And they were posted, too, in what they said, and said of their best. We have much to learn in this direction. Their papers in addition to being clear and perspicuous were fully up to date. There was not a useless word in them. The correct term was always used, and no time was spent in useless details. Long, tedious cases which proved nothing were omitted, and the result only tersely given. Modesty was always the rule, and I saw no exception. In fine, laying aside all national considerations and judging them , without bias, all must concede a fine body of medical men to Great Britain, whether we judg3 them professionally or socially. Learned and modest, gentlemen without ostentation, and of the highest skill, they are an ornament to a nation which to-day stands at her zenith, and in her high position may justly feel that pride to which her merits entitle. A few words will close my observations on the medical men. They have much to be proud of in the position and sentiment accorded them. None knew better than Napoleon the value of cultivating an esprit du corps. His teachings in France in this respect alone have largely made the nation what it is. This spirit is cultivated and extended by all European countries. Of no more honorable spirit than the devoted men of our own country, they labor in the certainty . 10 MEDICAL OBSERVATIONS ABROAD. that honorable rewards await true merit and scientific attainments. Medicine is looked up to and its votaries encouraged. To be a medi- cal man is to be assured of an honorable respect, and in itself is a sure passport to position. The students in London were seemingly of a high order of education but accustomed to too much license. There seemed no disposition to be observant of the rules of good breeding, in marked contrast to our country, where after an experience of several years as student and teacher, in Allopathic and Homoeopathic schools, in Louisville, Cleve- land, Philadelphia, New York and Chicago, I never saw the least of that rowdy spirit which I saw in London. It is conceded that it was " all in fun," and born of free spirits, but it lacked that unrecognized earnestness which makes the pupil, without thought and unknown to himself, quietly observant and watchful of every opportunity to learn, which is so marked a characteristic of the American pupil. It showed a disposition to be hilarious born of wealth and indolence, and frittered away the golden hours of life, disregarding the high advantages by which they were surrounded. A little well-learned and stored away at hand when wanted, makes a better medical man, than an abund- ance gaped at, and never digested. The continental students, and I especially mean those of Paris and Vienna, seemed out on a holiday. They never burned the midnight oil in study, rather in hilarity and abandon. The students' ball in the Latin quarter in Paris, where I mingled with them in viewing their sports, was a scene of wantoness and low fun better fitted for the slums of vice than recreation for the brain of the intelligent, and was a disgrace to those who habitually frequented it. In Great Britain the licensing authority is separate from the teach- ing. The colleges are part of the hospitals frequently, and located within their walls. No one can deny that their requirements are high and their standing good. In number they are too great to be even enumerated here, and the reputation of each seems to be regarded as the best by its own particular graduates. Probably on no one subject do such erroneous impressions prevail in this country as that of the legal qualifications essential to practice. We conjecture that all must be perfect in so old a country, and our surmises have been strengthened by the imaginative tales of travelers. The English laws decree just what the laws of most of our states do —neither more nor less— that the non-holder of a diploma is not com- petent to give medical testimony in a court of justice, or collect his MEDICAL OBSERVATIONS ABROAD. 1] fees by a suit at law. He may, however, practice when and where he chooses, providing he does not represent himself a graduate or licenti- ate, or infringe on the local laws. If he has a death, however, it may go hard with him. But the sentiment of the people at large is vastly different from that in this country, and he who has no license will find it hard to secure patients among the respectable classes. Already, however, the "Great King of Pain," and the "All-healer of Nations," and such quacks have arrived, and despite the trammelling surroundings of the grad- uates, throngs rush to be relieved by magic of incurable infirmities. For what I have said I have the authority of some of the most distin- guished Liverpool and London medical men, of high position and well informed. Parisian diplomas have long enjoyed a great reputation, and been eagerly sought after. Paris has one of the French faculties of medi- cine, the other being at Montpelier, their degrees being recognized all over France. The old building in which the lectures are given was inaugurated in 1776. has a semi-circular amphitheatre capable of accommodating 1400 students, a library of 35,000 volumes, and a museum replete with the most elaborate and instructive anatomical preparations. An addition to this building is in process of construct- ion, which will be very fine when completed. A separate school of anatomy exists, supplied by the hospitals. There are in all 96 stone tables, covered with zinc, four students to dissect at each table. Upwards of 4,000 cadavers are annually dis- sected. Numerous pathological museums also abound, that of Depuy- tren, Bonaparte's surgeon, being especially valuable. As you are aware, several world's medical conventions were held at the Palace of the Trocadero, and as one of the official representatives from this country, 1 had the pleasure of meeting many eminent men, of all other schools as well as of our own, from widely separated sec- tions of the world. It was a motley collection, that of the medical men in that far-famed city. It is doubtful if any other city could draw together such a body. There were present representatives from nearly every civilized and half-civilized nation. The '■ mall" of India jostled the " surgeon " of England, and " le medecin '*of France, " il medico" of Italy, and " die arzt" of Germany all chatted together in that uni- versal tongue, French. A Bedouin Arab, in his native garments, as were the representatives of all the various nations, surprised me by turning and addressing me in French, while a Chinaman, keenly judg- 12 MEDICAL OBSERVATIONS ABROAD. ing from my accent, told an Englishman near by, greatly to the latter's amusement, that I was " allee samee likee " him, which on interroga- tion I found to be true, he being from California. It is not likely that ever again shall I meet in such a body, and while I tortured myself almost to bewilderment, in endeavoring to understand the terrible pronunciation of a language which I presume I treated as severely, and while I probably gathered litLe information, I shall' remember the odd acquaintances and the novel sensations experienced, the laughable mistakes and genial half-understood hilarity as one of the pleasantest and queerest experiences of my life. In the convention of our own school we numbered many of the most distinguished continental physicians and surgeons. We may be proud of those there assembled, and I would call your attention to the names and papers which will soon be officially issued by the French govern- ment. The remaining medical schools of prominence, have been alluded to in connection with the hospitals. They all enjoy a high rank in their countries, and many have a reputation over the continent and abroad. Passing between Vienna and Berlin, a pause was made at Leipsic, to view especially its great college, and see the celebrated monument to Hahnemann, the founder of our School. The latter stands in the Theater-platz, surrounded by green trees and verdure, and is a fitting tribute to him who so well deserved it. At present it is the largest one to the memory of this distinguished man, but a fine one is soon to be erected to him in Pere la Chaise, the great Parisian city of the dead. The Botanic Gardens of the old world are well worthy of a visit. Those near London, called the Kew, are especially interesting. They embrace 270 acres, and in the open air or under glass, contain the flowers, plants and vegetable curiosities of all countries. It is hard to describe the effect of these beautiful grounds. The Palm House is the largest in the world, wholly composed of glass, sixty-four feet high, with trees touching the highest points. Hot-houses in long ranges grow all the ferns, cactuses and orchids of the known world; huge tanks of hot water float the lillies,the Papyrus and Lotus of Egypt, and the lace plants of Madagascar. In fine, it is the true boast that no plant is known whose counterpart is not here. Cinchona plants grown here have alone saved the kingdom millions of dollars. Those in Brussels are also good; those in Paris, world-celebrated. The latter cover a surface of 267,620 square metres, and are admir- MEDICAL OBSERVATIONS ABROAD. 13 ably arranged. The colors of the tickets denote the uses of the plants; the green, alimentary plants; the red, medicinal; the black, the poisonous; etc. An elegant cabinet of comparative anatomy is also here, as well as a menagerie, etc. The time and attention given to recreation and health-keeping is very apparent. A day's labor in Europe among brain-workers is not a day's labor in America among the same class. A visit to their watering places shows a class of visitors not seen in ours. This is especially apparent in Great Britain. Cheap trains at suitable hours are run, and a Sunday at Brighton and other sea-resorts demonstrates their value. Who that travels through Germany but notices the same thing V Who that recreates at Baden-Baden or Wiesbaden, two of the most attractive spots in Germany, and unexcelled in the world, can stroll down the Lichtenthaler Allee or wander in the Cursaal Park without noticing the great number and classes of people who come to drink the waters, bathe, and while away a few hours ? The Emperor and the Crown Prince, the artisan and the laborer, the merchant and the physician are all there. Who that ever spent an evening in the Piazza of St. Mark in Venice, the Volksgarten in Vienna, with Strauss' delightful band playing his ever-popular music, wandered through the Galleria Vittorio Emanuele in Milan, the Kaisergallerie in Berlin, drank his beer in the Prater at Vienna, his wine in the Corn-Hall cellar at Berne, or his coffee in the Cafes Chantants at Paris, but felt how much better with us would be more light recreation for the poor as well as the rich V We have, it is true, our health resorts, but in the bathing of Long Branch or the drinking of the waters at Saratoga, there is not seen that freedom from style without slatternliness which is apparent abroad. We have yet to learn the ways of personal pleas- ures for the many at slight expense. Let us hope we can learn it with- out the selfishness which too often attaches abroad, and mars the beauty of the realization. The sanitary condition of all foreign cities as a rule is much better than ours. Time and money, such as only empires can spend, have built them on sure foundations, and given them a secure basis. It would be difficult to find large cities better attended than Paris and London. It is true not all are modeled after these great wildernesses. Cologne sends up an unknown number of odors, seemingly proving that her celebrated water is better known abroad than at home; Glasgow cannot boast of the region about the Salt-market and through 14 MEDICAL OBSERVATIONS ABROAD. High street; Vienna might improve very materially her back-waysT and forestall another cholera epidemic; and even Venice, to find fault with which is not to be forgiven by the average tourist, might purge her canals with great relief to the atmosphere, But in the main they are all good, while Brussels, Frankfort, Dresden, Trieste, Milan, and the smaller cities all through Switzerland, and generally in France, were well kept and carefully cleaned. The time was when New York could rival Paris in her cleanly-flowing gutters and carefully-collected garbage, and the time must come when an efficient sewerage system will supplant that of our low-lying cities and prevent such scourges as some sections of our country have recently passed through. The Parisian system of sewers, world-renowned, is in actual use, and a sight for a medical man delightful to see. With a boat or on foot, one may pass from one part of the city to the other with cleanliness and comfort. The climate of Great Britain is too well known to comment on. In its pleasantest moods it is fairly agreeable; in its more common states exceedingly unpleasant. Foggy and rainy, it has its effect on the mind, and gloomy spirits and consumptive bodies must result. It has a compensation, however, in being favorable to the complexion, and has given the ladies a renown they well merit in this direction. The climate of France is genial in the south, but not so generally in the north as seems to be the common impression. The summer even- ings in Paris are much like those of our own city; Berlin is rugged and chilly; Vienna subject to changes of temperature surprising even to a resident of Chicago. The balminess of Italy is well-known; its terrible heat is not so generally spoken of. It is indeed as Byron so happily wrote : " —the garden of the world, the home Of all Art yields, and Nature can decree; E'en in thy desert, what is like to thee ? Thy very weeds are beautiful, thy waste More rich than other climes fertility, Thy wreck a glory, and thy ruin graced With an immaculate charm which cannot be defaced." Around the lakes Como, Maggiore, Lugano, or Varese (the latter perhaps the most beautiful of all in its setting), resting at such ele- gant hotels as are found at Bellagio, Mennagio, or Varese, the heat tempered by the gentle breezes, and the eye resting on the light and shadow of the slowly receding afternoon sun, as it sinks away in its MEDICAL OBSERVATIONS ABROAD. 15 western bed, there steals on a sense of rest and quiet most grateful to the wearied, driving away thoughts of the morrow, dull care and pain. No more delightful spots can be found for a patient worn-out and desiring rest of mind and body, for what a bountiful nature has omitted, a comfort-studying art has supplied. The valleys of Switzerland have borne the fruit of foul air and insufficient food and cleanliness in its most disgusting form,—cretin- ism. Happily it is fast disappearing under the present rule, and promises to be wiped out ere long. But her high mountains and clear air, her scenery beautiful and attractive in every direction, may well class her varied resorts as among the finest in the world for the patient wearied in mind but sound in body. Nothing could better tend to restore the shattered mind than a tramp over the mountains, or a bracing ride through the most wonderful of scenery. Who that has rolled over the magnificently-builded Simplon road, scrambled over the Col de Balme, Tete-noir, Brunig, or any of the famous Alpine passes, but knows the exhilaration of spirits attendant on such a trip ? And he that has passed along the Valley of Chamouny, at the foot of the world-known Mont Blanc, waded on the Mer de Glace, sailed on the lakes of Geneva, Thun, Brienz, Lucerne, or Zurich, tarried at Vevey, Villeneuve, Ouchy, or Berne, or paused in the majestic Black Forest, can select a dozen spots for his country-fleeing victim of disease.