season, and to eat them out of season in a climate calling for a good, nutritious diet, not a mere filling up with material that is almost entirely waste, is pushing the elasticity of nature a little too far. Tropical fruits are brought thousands of miles to ripen, and are so abundant and cheap as to be consumed by rich and poor the year round.

Such changes in diet must produce some effect in the animal body, and give a somewhat different pabulum for the microorganisms of disease to work upon, and hence produce changes in the types of diseases different from those described by the older authors.

IMPROVED CULTURE.

Perhaps the greatest change in the last thirty years has been within the profession itself. Medical colleges have sprung up and multiplied like mushrooms, and while many of them are not what they should be, having been organized simply as money-making institutions for the benefit of the pockets of those connected with them, the majority of the colleges are doing good work, especially the older ones situated in the large medical centers. A number of colleges have opened their doors to the fair sex, and now we have the ladies with us in the profession, and they are showing us that women can do what was considered in the past to be a man's work. God bless them!

There can be no doubt of the fact that in general the graduate physician of this day is far better equipped theoretically than was ever known in the history of the profession, and he has also a certain amount of practical experience gained from observation under the guidance of others, but not that experience which is only obta'ned by being thrown upon his own resources in private work. Many of these graduates, after a pleasant year in Europe, or a little extra study at home, seek the royal part of practice, by starting out immediately as specialists in one of the many fields in which medicine is minutely divided at this time. The increase in the number of specialists has been more than rapid, and in cities they are almost as numerous as the general practitioners. It is here we note a great contrast, for there were but few specialists thirty years ago, and they were men who had practiced medicine for some years, and from natural ability, or force of confidence coming from their brother physicians, had gradually limited their labor to one of the few subjects looked upon as special fields of work. These men were equipped all around, they had served a full apprenticeship,

and could examine their cases through the eyes of a general practitioner, noting all that bore upon the special disease, and then, bringing special knowledge to bear, would give advice of value. It has seemed that the days of the general physician were numbered and of short duration; that they must become nothing but mere feeders for the specialists; and in the medical journals more or less uneasiness is expressed about the passing of the general practitioner. Fortunately, the people, those who should be uneasy, have taken the alarm, and the palmy days of specialists are on the wane, and unless the specialists build a firmer foundation to support the top-heavy superstructure they have reared, they will have to call upon the general practitioner in order to treat intelligently their

cases.

We read a great deal about the great advances in the science oi modern medicine, and this seems to be a favorite topic with the many purely journal physicians, who are continually ventilating their ideas in the pages of the almost numberless advertising medical journals which exist, but do not flourish. The study of medicine may be a science, in that it is the study of classified knowledge, but it is indeed a question whether the practice of medicine is any more of a science to-day, or will be any more of a science in the future, than it has been in the past. When this classified knowledge comes to be applied, it is found that no two subjects are alike except in generalities, that no disease gives exactly the same symptoms or runs the same course in any two subjects, or even in the same subject when affecting it twice; and again, a disease will act differently in different seasons of the year and in different epidemics. A remedy does not always give the same action upon any two individuals, nor upon one individual at different times. No two physicians, equally learned in this classified knowledge, will apply it in handling a disease in the same manner, and with the same symptoms before them they will often not agree even as to the disease. With such variations in the practical application of medical knowledge, it is not surprising that the many formulated treatments that burden the journals should prove failures, and it does not seem correct to speak of the practice of medicine as a science, or expect that it can ever be such.

PREVENTIVE MEDICINE.

There is one department of practical medicine that is a science, pure and simple, where definite results follow the application of definite knowledge, that of Preventive Medicine, and this has made

the greatest advance of any in the present generation, although it is about the oldest, going back even to the time of Moses.

Some may claim that surgery bears the palm, for forging ahead to the accomplishment of results that border upon the marvelous. Our surgeons are doing great work, still they are no more skillful in the use of the knife, if as skillful, as those of the past. Considering the difficulties the surgeons of the past had to contend against, the operations they devised and performed showed a boldness and skill ahead of the present day. The surgeons of this day proceed with but little hesitation to perform operations that would have resulted formerly in death, not because of any superior skill, but because they have confidence that septic poisoning, the dread of surgeons in all times, will not step in and destroy their work, and this confidence has been brought about by the advances made in preventive medicine.

Starting with Lister's antiseptic method and following surgery down to the present, through all of the substances used as germkillers, and the ideas for applying them, we come finally to the present efforts for absolute cleanliness, not only of the instruments and surroundings, but also in the person of the operator, assistant and patient. Germ-killing solutions are abandoned for water freed from germs by distillation or boiling, and dressings cleansed from germs by heat have taken the place of gauze impregnated with germicides. Life only can produce life; living germs must be present to produce germs; hence, keep away germs from the wound and sepsis cannot follow. This is what the surgeon means by asepsis, and the results obtained are wonderful illustrations of the value of the science of preventive medicine, a science that has been developed by the physicians of the past and the present. Applying the results of this work of the physicians, the surgeons have been enabled to mount the pinnacle which they now occupy with such self-satisfaction and pride.

This branch of practical medicine is based upon demonstrable scientific principles, and calls into action the skill of the chemist, the physicist, the pathologist, the physiologist and the bacteriologist, and it is from this that the greatest advances in the future are to be expected. Pure air, pure water and pure food will work wonders, but to get these and fully apply teachings of hygiene, will require the concerted action of the national, State and city governments, giving authority and the means with which to work.

In conclusion I will say that it is not my intention to belittle in

any way the experimental work tending to advance medicine. I simply wish to impress the idea that in this period of shaking our own hands in congratulation at living in a time of such advanced and enlightened thought, and being freed from what we style the ignorance and superstition of the past, we must remember that what has been accomplished in recent years was foreshadowed by the thinkers and workers who have gone, and that they thoroughly established the groundwork upon which we are building. We must not forget that without the pure sciences of chemistry and physics to aid, we could have done but little, and that great credit is due to the skilled mechanic who under the guidance of the scientist has so perfected and cheapened the instruments of precision as to place them within the means of the many instead of the tew, especially the microscope, the great engine of modern medical ad

vance.

Furthermore, while we have more to work with, we have more to contend against, and it behooves us, who practically apply the many new theories, and handle the new remedies, to move carefully and not jump at conclusions of our own, nor too readily accept the snap-shot conclusions of others; that we should not allow the cupidity of any one for fame or money to influence us to give up the old and well-known for the new and comparatively unknown.

THAT PROVERBIAL CURE.-Belief in the curative powers of "a hair from the tail of the dog that bit you" is not yet extinct, and the proof of that fact came this week to the doctors in charge of the St. Louis City Hospital. Under their charge is a little German bəy who is recovering from injuries inflicted some weeks ago by a dog whose ferocity was the result of the animal's disposition and not of hydrophobia. The child's mother was not satisfied with the treatment he was receiving, and she appeared at the hospital with a little bundle, which, after many wrappings had been removed, was found to contain a few yellow bristles about half an inch long. "I had some cure," she said very gravely. "My neighbors they tell me of him, and all says if I vill put some hairs from the end of her tail von der dog what bit mine kind, he vill pe sure get vell. So I goes to der man vat has das dog, und er gives me de hairs, und I haf bring dem, und vill safe mine kind." The doctors attempted to explain that this phase of homeopathy was somewhat out of date, but the woman's faith in the remedy was so strong, and her distress at its being discredited was so great, that they were forced to promise that her wishes should be carried out.

TOPOGRAPHY, CLIMATE AND MINERAL SPRINGS

OF MICHIGAN.

By A. N. BELL.

Michigan lies between 41° 42′ and 47° 32′ north latitude, the meridans of 82° 24′ and 90° 31' west longitude from Greenwich, and occupies an area of 78,915 sq. miles, of which 1,485 sq. miles are water surface.

It consists of two peninsulas, of which the lower, resting on Ohio and Indiana, and bounded on all other sides by the lakes and their connecting waters, extends 300 miles northward, with an average breadth of 200 miles; while the upper, resting with its southwest border on Wisconsin, extends eastward between the lakes to St. Mary's River, the outlet of Lake Superior, with a length of over 300 miles and an average width of about fifty-five miles.

The physical features indicate that during the glacial epoch the whole of Michigan was buried beneath several thousand feet of ice, which flowed in a southerly direction and greatly modified the previous topography.

In the lower peninsula, where the rocks, eroded by glacial action, lie deeply buried, the relief of the land as now seen, is almost wholly the result of the deposition of clay, gravel, sand and boulders by glaciers, and by the streams flowing beneath the ancient. ice-sheet, or issuing from its margin.

Imperfect drainage has left thousands of lakes filling depressions in the surface, while thousands more of shallow lakes have been filled with marl and peat, and now form swamps, or have been drained and furnish rich soils covered with luxuriant vegetation.

Over considerable areas there are no surface streams, the rainfall being conducted away by percolation. Beneath the general covering of glacial deposits there is a system of stream channels, excavated in hard rock, traces of which are in some places recognized on the surface, or discovered by wells and borings, but with no immediate relation to the present surface drainage.

In the lower peninsula there are several elevations of from 100 to 700 feet above the lakes, but these are seldom abrupt and are scarcely distinguishable in the generally monotonous topography. Through the central portion of the peninsula, from Saginaw, south