Amoy where the plague had gained a foothold. There with the small quantity of serum in his possession he treated 23 cases of which 21 recovered. As this occurred during the decadence of the pest it was not considered conclusive evidence of its value. When last year plague broke out in Bombay and deaths had increased from 50 to 150 or 200 a day, there was no treatment of any particular avail. Prof. Haffkine and Dr. Hankin and his assistant Dr. Gadially had made a careful bacteriological study of the disease. These men, whose acquaintance I had the pleasure of making last December, were careful, untiring scientific workers. According to their experience the period of incubation is from three to seven days and contagion may be by innoculation through local abrasions or by systematic poisoning. The disease usually runs its course rapidly, three or four days usually being the limit.

The mortality at the beginning of an epidemic, as for instance at Karachi, which became infected from Bombay, was about ninety-three per cent. Prof. Haffkine made an extract from a pure culture of the bacilli and was using this as a prophylactic against the disease. He was the first to submit to the injection. A mild reaction followed with enlarged lymphatics and in three days complete subsidence of all symptoms. Two thousand people have been innoculated by Haffkine's serum and only four of the number, according to the latest reports, have succumbed to the plague subsequently contracted. Prof. Haffkine uses this serum in the treatment of cases. Dr. Hankin, who lately became a victim of the disease, got well under treatment with Haffkine's serum. Dr. Yersin, when the plague commenced at Bombay, began the preparation of serum at his station in the east in Annam. It takes about six months to prepare the horses for useful serum and it was not until late in March that Dr. Yersin came to Bombay witth a quantity of serum sufficient to treat three hundred people which he has used, but his own official reports of the effect of treatment I have not received, the first report after a week's work in Bombay being the last authentic report I have at hand. He promised then to make

a full report in the India Times of the effect of treatment. Telegrams, however, report quite as good success with Haffkine's serum as with that of Yersin, and still the mortality, notwithstanding that the epidemic has existed now over nine months, is fully fifty per cent. of those attacked. Proper medical organization in India might have brought sufficient pressure to bear on the Indian government to have prevented the spread of the pest to adjoining cities as to Karachi on the north and Poona on the south and nearly destroyed the trade of India with the world. India had no such organization, and though she has able, well educated physicians, there could be no concert of action till a very late period.

Serum-therapy in the diagnosis of typhoid fever is also promising to throw some earlier light on this malady, which in the eastern world, especially in India, proves so fatal to the young British soldier. Pfeiffer's serum is spoken of favorably and it is hoped that it may prove to be a certain test for the enteric bacillis. The fatality in India from enteric fever is very high. Last year in the military hospitals there were one thousand eight hundred and seventy admissions and four hundred and seventy-seven deaths.

Kruse says that the "differential diagnosis" of the typhoid bacillus is a far more complicated operation than it was formerly. "No single character," he writes, "is peculiar to the typhoid bacillus; only by the presence of all its characters in their totality can it be differentiated; and," he added, "a certain variability, however, attaches to some of the characters." Pfeiffer remarks that cholera bacilli have been satisfactorily identified in a whole series of cases, but "on the other hand the statements hitherto made regarding the finding of enteric bacilli in water are to be criticised very sceptically." In this field Professor Hankin has also been busy. He has found that "there exists a whole series of intermediate gradations between what he believes to be the typical enteric microbe and the bacillus coli communis." Practically, however, as he goes on to point out, this fact does not make so very much difference, as "very generally when these are detected the enteric microbe can also be found if sufficient care

be exercised. It is clear," he adds, "that microbes allied in their culture characters to that of enteric fever are found so rarely in the absence of the typical microbe as not greatly to detract from the value of the test." Dr. Gadially, Mr. Hankin's assistant, has also recently noticed that when a particular microbe is present in specimens of water or milk the enteric microbe is never met with. On being isolated it was found that this micrococcus has the power of destroying the enteric fever microbe in water, bouillon and milk. Mr. Hankin hazards this conjecture that the presence of this or similar microbes in bazaar wells may account for the immunity from enteric enjoyed. by those who use them. "Drinking their water may produce dysentery, malaria, cholera or liver abscess, but," adds Mr. Hankin grimly, "it would appear to be the way to avoid enteric." The discovery of this bactericidal microbe, fatal in its effects upon the bacillus of enteric, seems to be the nearest approach which the analysts have yet made towards grappling with the cause of the scourge. Of course one might as well die of enteric as of cholera; the alternative presented by Mr. Hankin is not a pleasant one; but it will be admitted that the existence of a microbe which is as merciless toward the enteric microbe as the enteric microbe is towards man is a valuable discovery, pointing to a line of least resistance in the struggle against disease which may in course of time be overcome.

Many of our young men with the advantages of preparing themselves in lines of original research have an ample field for them and a rich harvest of fame is waiting to any one who can throw new light on the cause of disease or its cure when it exists. Let us ever remember that hard, honest, earnest

work always pays, and that

"Not a truth has to art or science been given

But brows have ached for it and souls toiled and striven.

He that overcometh shall all things inherit."

Mr. President, Ladies and Gentlemen:

Some one has said "Novelty is the spice of life," and if he spoke truly, I come to you with spices; for surely a paper which discusses the business part of our profession is a novelty. The records of our society offer no precedent, while hasty excursions through the world's medical literature discovered no predecessor who has discussed the third part of our profession as I am to discuss it to-day.

What I say may not be spicey, clever, pleasing or even original, still, it will be peculiar, for I shall forsake the pleasant paths of science and art to introduce their vital consort, business.

An introduction seems necessary, for, year after year this great medical society has courted and flattered science and art, but has not recognized business. It is true we have our business sessions, but they refer to the business of this society, and not to business as a vital part of our every day profession. If the venerated spirit of Aesculapius had been with us at our annual gatherings, long e'er this it must have decided we had reached that ideal stage of evolution in which science and art are all our profession needs, business principles and their important offsprings being quite unnecessary. Last fall I

informed one of the professors in our State Medical College that I proposed addressing you on the business principles of our profession, and he advised me to select some other subject; that the true physician did not work for money; that his object should be the relief of suffering; that the real scientist forgot himself in his earnest search for knowledge, and that the soul of art should not be contaminated with sordid thoughts of money getting. Eloquently he dwelt on the ethics and altruism of our noble profession, endeavoring to prove that it could advance only when it forgot business and aimed at its highest ideals. As he talked, my heart burned with a new pride for my life work, but, noticing the costly ring on his finger and the flashing diamond in his tie, I was rude enough to say it was easy for him to pass over the business part of our profession as he received a magnificent salary from the state, and since times were bad the state should cut salaries in two; quick came the reply, that if it did he would resign. It is pleasant for us to dwell on the unselfish good samaritan character of our profession, but we must eat and drink, buy clothes and pay taxes. We must have business methods to deal with the business world. The publisher wants pay for his books, while the surgical instrument dealer cannot supply us with iustruments unless we pay him cash. The monthly rent day returns with unfailing regularity, and our insurance policies lapse if we do not remit. The world may say kind words about us, but it demands our money whenever we receive anything from it. Every where and every day every one of us is confronted with perplexing business problems; yet I fancy I would have given you a well developed shock had I come before you with a paper on "How to collect," "When to send out bills," "Office fees," "How to increase charges," "How to furnish your office," "How to conduct a consultation," "The manners of a physician," or any one of a hundred similar questions that puzzle each and all of us.

I have endeavored to be a judicious medical student; I have paid for and listened to courses of lectures in six medical colleges, besides attending different medical societies; yet I have not heard one lecture or paper on the business part of our