In London I met Jonathan Hutchinson, fresh from his investigation of the relation between fish diet and leprosy, carried on at the leper settlement off the coast of South Africa. The results were to be given at a meeting of the London Medical Society, but unfortunately I could not stay and hear them. They are doubtless in print before this, and I am sure will prove interesting. He told us that a new danger threatens the drinker of beer. It was thoroughly established, at the time of the recent investigation of the epidemics of multiple neuritis in various English cities, that arsenical contamination of beer took place through the use of impure sulphuric acid in making the glucose used in one of the processes. It has recently been learned that the malt. itself contains arsenic from the fumes of coal over which it is dried. The occasional occurrence of cancer in those to whom arsenic has been administered therapeutically is well recognized. Mr. Hutchinson enthusiastically supports the proposition that the great increase in cancer, known to be largely in males, may well come from the use of beer contaminated with arsenic, probably in too small quantity to give rise to toxic neuritis. Sir William Gowers invited Dr. Spencer of Cleveland and myself to make a visit with him to the Hospital for the Paralyzed and Epileptic, near Russell Square, where so much of his great work has been done. He is a believer in the use of "muscle education" in the treatment of locomotor ataxia, and says that much good results from proper exercise in early stages. He uses also a "go-cart," by which patients support themselves. By this means those wholly unable to walk otherwise move about comfortably. I saw little of medical matters in Paris and Berlin, but hastened to Vienna. The American contingent here is now very strong, probably 150 physicians being present. I have met less than half a dozen from Great Britain. The Mississippi Valley is especially well represented, many coming from Ohio, Illinois and Minnesota. I have met four physicians from Texas, and one, Dr. Abbott, a lady physician, from Colorado. So far I seem to be the most "Western barbarian.” American ideas, American names, American money and American enterprise are less in evidence here than in England, France or Germany, but are still fairly prominent. In medical matters, Nothnagel seems to be the recognized leader here. As a lecturer he is superb. His fine presence, his clear enunciation and his known mastery of his subject combine to make him easily the most popular lecturer. One American physician, long resident here, says that it is commonly believed that he has no superior in German-speaking lands, if indeed in Europe. Neusser, while considered one of the first physicians of the time, is at the opposite pole as a lecturer. He does not look up during the lecture, not once, and speaks in a very low tone; only those in the front seats hear him easily. No one commands higher respect, however, so far as the substance of the lecture goes. Chvostek lectures three times a week on nervous diseases and twice on physical diagnosis. He is a fair lecturer, and both courses are popular. The finest thing in Vienna, to an American, is, however, Albrecht's course on pathologic anatomy. It is given to a class of twenty, and all are Americans at present. The 3,000 beds of the Vienna General Hospital contribute an amount of pathological material that is wonderful to an American, accustomed to see his most interesting cases leave him without the formality of an autopsy; no such hindrance to medical science exists here. To-night, for instance, twenty-eight platters contained the organs from the autopsies of the day. In a demonstration of an hour and a half Dr. Albrecht took up the most interesting features of the various exhibits. The removal of the parts wanted from the body is done with so little regard for the appearance of the corpse that every feature of the disease can be demonstrated, regardless sof the portion of the body involved. It will gratify the surgeons of Colorado to know that the lecturer to-night spoke with especial force of the comparative infrequence of cases of cancer of the uterus in the pathological room since the more general introduction of surgical measures of treatment. Most cases now have been operated, so that many of these that finally appear in this department show the disease in parts more or less distant from its original seat. To those of us who have made the error of regarding typhoid fever in a child as tubercular meningitis or cerebro-spinal fever, it will be a comfort to know that Albrecht to-night demonstrated the organs of a body of 2 years, showing the usual lesions of typhoid in a case regarded as obscure meningitis up to the time of finding a Widal reaction. The diagnosis is not possible otherwise in certain cases, so far as one can learn here. I have neither seen nor heard of another case of typhoid since my arrival, nor of our American disease, appendicitis, but doubtless shall see them both in a wider experience here. Although I have not in my first fortnight attended any gynecological exercise, from the number of clinics and the fact that every other American physician seems to be taking two or three courses, I judge that this branch is to lose none of its. popularity in the immediate future. The American tendency of late seems to be distinctly toward the breaking down of the barrier between surgery and gynecology, and properly so, I believe. No such obliteration of old lines is to be seen here. The departments of obstetrics and pediatrics are more closely associated than with us. I have attended but one surgical clinic thus far, that of Von Eiselsberg. He is a clear, forcible lecturer, but I did not. see him operate. I shall try to report later regarding surgical matters in a very general way. The most notable feature to me in the skin clinics is the occurrence of many diseases practically unknown to the general practitioner in our part of America, to me, at least, either in appearance or name. The conditions attributable to vermin, uncleanliness and unhygienic conditions of life are certainly much more frequent than with us. As has been so often remarked, Kaposi's position remains unfilled. The first assistant, Krabech, is an excellent teacher and draws many students. The condition of the medical man in Austria is apparently not what it should be, from what I learn in conversation with many physicians whom I meet. One Vienna physician told me that 2,000 of the 3,000 doctors of this city do not make a living in the profession. Fees are low, many patients seek the hospitals and free cilinics, and regular attendance by the medical adviser seems uncommon except in most serious illness. Conditions are even worse in the country districts. I think most of our physicians will return better satisfied with America. -J. N. H. Effect of Carbon Dioxide on Digestion.-The good effects of aerated waters in fever, says Penzoldt (Medical News) are to a great extent due to the stimulating influence of this gas, and in anacidity and mild atony they will undoubtedly be beneficial. 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