employment to this class of people who ordinarily must beg to gain a livelihood.

On the second floor was a store room filled with hundreds of large stone jars. These were variously labeled, two, four, six or eight flavors, the quality and price increasing with the increase in the number of flavors. Upon the roof were a large number of mats spread out and covered with herbs drying. In still another department men were wrapping medicine in paper, then placing it in a small bulb of wax which was afterwards sealed. There were great quantities of a black tar-like paste which was being put up in the form of plasters. It is a common sight to see these plasters which are put on the forehead for the cure of headache. The firm does both a retail and wholesale business and judging from appearances must make an enormous profit. After another house-boat trip of 120 miles we came to Soochow which next to Canton is one of the most typical of Chinese cities, there being very few European or American residents aside from the missionaries. In passing through the streets many pitiful sights are seen for often when a person is seriously ill he will be cast out into the street to die. In the court yard of one temple was a beggar with both legs cut off above the ankle. The stumps were excoriated and in a terrible condition. Through an interpreter he was directed to the missionary hospital but often such beggars prefer to suffer in order to make money.

One of the best pagodas of China is in Soochow and from it a fine view is obtained of the city with its so-called dragon street, probably named from its winding course, though many believe that a dragon lives under it. Another noted street is called dog-bite alley, so narrow that it would no doubt be hard to escape from an excited dog. As in all the large cities, there are public execution grounds with a stand for the magistrate to witness the beheading. The prisoner is usually summoned from jail and is at first uncertain whether it means freedom or death, but as soon as he finds a chair in waiting he needs no further notice for the prisoner is always taken to the place of execution. in a chair.

China seems to be making a strong effort to rid herself of the opium curse, for during the past year many of these dens have been closed. Only a year ago dens were open in Soochow and in almost every city we visited. The majority are small places. As one enters the door there is a small anteroom where the opium is purchased usually in a paste form on a small piece of paper.

After procuring the opium, the Chinaman goes into the next room, reclines on a bench or wooden couch and enjoys his pipe peacefully. Many of the physicians have endeavored to do all in their power to aid those already addicted to opium. While great improvements are made in many cases and some cures are reported still the general opinion seems that the percentage of permanent cures is small. It is to be hoped that Great Britain and the other powers will aid China in lessening one of her greatest evils. Another evil which China is attempting to eradicate is that of foot-binding. Many theories exist concerning its origin. One being that years ago a princess was born with deformed feet and in order that she might not feel embarrassed all parents were ordered to bind their children's feet. Others say that it was for the purpose of keeping the women at home. Whatever the origin may have been it became customary, and custom is hard to break, in China. There is a Chinese proverb which says: "a pail of tears for every bound foot." There is an impression that foot-binding is only practised by the wealthy families. In our travels in out of the way places in the region of Canton, it was a common sight to see peasant women with feet so tiny that while they were carrying loads with their bamboo sticks over one shoulder, it was necessary for them to carry in one hand a staff to help their balance. During my frequent visits to the various hospitals there was opportunity to examine these bound feet. The entire weight of the body seems to fall on the metatarsal bone of the great toe, the remaining metatarsal and the tarsal bones are so pressed together as to render it difficult to distinguish their outlines. There is in my possession a pair of shoes which were given to me by the wife of a Mandarin, a patient who was operated upon for vesical calculus. These shoes are but three inches in length, though the woman was well formed in every other respect, being of more than the average size of Chinese women.

In former times a Chinese gentleman refused to marry a girl unless her feet were bound, but today they are beginning to refuse the girl whose feet are bound. This will be a more effective measure against foot-binding than any imperial edict.

In Soochow there is a medical school established 20 years ago, and now in connection with the Soochow University. Dr W. H. Park has charge of the men's hospital and Dr M. H. Polk the hospital for women. After the establishment of the women's hospital the ladies joined in carrying on the school and two sets

of certificates are used for graduates, one in the name of the men's hospital and one in the name of the hospital for women, the work in other respects being the same for both. The course of study has extended over five years and the graduates, scattered over various parts of the Chinese Empire, maintain themselves so well as to give the school a most excellent reputation. The Tooker Memorial Hospital, a woman's hospital, in Soochow, is in the charge of Dr Frances Cattell. The year previous to my visit there were over 5,000 dispensary cases and about 100 in-patients. Not far from the city of Ningpo is a place called Yu Yiao. It is in this region that there is a great population, in the neighborhood of a million, without the advantages of a hospital or foreign medicine science. There is scarcely any opportunity in the world for more effective philanthropy than the building up of such work in this district. We returned once more to Shanghai, then took a steamer for a journey of 600 miles up the Yangste river to Hangkow stopping on the way three days at Nanking. The journey from Hangkow to Peking, 750 miles, is made by an express train in 40 hours. Within a few hours ride of Peking we stopped at the city of Paotingfu. Here are two hospitals, one the Hodge Memorial Hospital for women, conducted by Dr Maud Mackey, and the Taylor Memorial Hospital for men, conducted by Dr Chas. Lewis. Dr Lewis was at the time on his furlough in America. Dr Mackey gave many interesting accounts of her work and told of some of the expressions of gratitude from the 80 or 90 patients who daily frequent the dispensary, or are patients in the hospital. One woman sent a thousand eggs to show her appreciation.

It is appropriate that in the capital city of the great Empire of China there should be established a center for medical instruction. The various missionary bodies, instead of endeavoring to carry on their work separately, have united, and as a result have established the Union Medical College of Peking. The new college building was dedicated in February, 1906, in the presence of the representatives of the Empress Dowager, of the Princes of the Imperial House, of the foreign powers and officials of the various boards. The building and equipment cost over $50,000 of which the Chinese contributed over one third.

There is a lecture room and teaching accommodations for over 300 students, the idea is to admit 70 to 80 per annum for the course which covers five years, of nine months each. In the

hospital 40 to 50 patients can be accommodated. It is planned to build a second hospital close at hand and devote the whole of the present buildings to college work. In the meantime the rooms which are destined for lecture rooms can be utilized as dormitories or wards for patients. There were 200 applicants for admission, 40 of which were received in the first class. The course of study is arranged so as to teach the fundamental branches in the first two years by lectures and laboratory work and to give training in medicine, surgery and the specialties during the last three years.

It is expected that in the last three years the students will assist in the wards, clinics and operating rooms. In addition to the hospital attached to the college the other mission hospitals and dispensaries in the city are open for the clinical training of the students. Government diplomas will be conferred upon those students who succeed in passing the final examinations. The faculty consists of 12 American and English physicians and about the same number of lecturers, all men of the highest standing. Of all the work in China, this seems one of the most encouraging for the future high standing for medical education.

In the West Shantung Province we visited Tsing Tau, Weihsien, Chinanfu, and Chingchowfu. The medical progress here is much the same as that described in the other cities and here also there is an effort to bring to a better completion an organized union medical work. Dr Arthur Smith says that China has made relatively more progress in the last five years than any other nation in the world. In Nanking we saw a little temple with the following inscription on it: "This is a little temple but a mighty big god dwells in it." Unconsciously, perhaps, we in America have had a poor opinion of the Chinese and their abilities. China now bids fair to outdo her teachers in all those things in which she was most backward. What would do for China asleep would not do for China awake. Our efforts to do our share towards her medical progress are still inadequate, but we hope the near future will show an awakened interest.

(Concluded in November issue)

European Eye Clinics

By LEO WOLFENSTEIN, M. D., Cleveland

The American clinics in the east probably furnish better opportunities for practical work in ophthalmology than one can obtain anywhere in Europe. But along strictly scientific lines the European, especially the German, clinics are as yet our superiors.

Of the continental cities Vienna is still the Mecca of the American physicians who come to Europe to study. This is partly on account of the fame of the old university and partly because the principal clinics are so conveniently situated within one large building, the Allgemeines Krankenhaus, so that one can see a great deal in many departments with little loss of time. Moreover there is an American Medical Association to assist those who are unacquainted with the German university system and are not proficient in the German language. In addition to this, almost all the professors, docents and assistants speak something which they claim to be English and which an intelligent American can learn to understand within a week.

The principal eye clinics in Vienna are also in the Allgemeines Krankenhaus. They are the first eye clinic (founded by Van Beer) now often spoken of as Jaeger's clinic, but at present under Prof. Schnabel, and the second eye clinic (formerly Arlt's) under Prof. Fuchs. The latter has about 24,000 new patients a year, fully double the number of the first clinic. There is a certain rivalry and jealousy between the two, which is said to be traditional, but nevertheless they are run in a similar fashion.

The American physicians, because they are a source of a great part of the income of the assistants, are personae gratae at all of the clinics, and generally have the privilege of visiting anywhere and following the entire work of the clinics. They also have no difficulty in becoming so-called voluntary assistants in any clinic they please.

In Fuchs' clinic there are five regular assistants and an indefinite but large number of voluntary assistants. Each of the former has charge of a ward of about 20 beds. The professor comes to the clinic at 8 A. M. and makes his round of the wards.

Read before the Ophthalmological and Oto-Laryngological Section of the Academy of Medicine of Cleveland, April 24, 1908