his quiet Viennese home, he conducts you over his comfortable grounds, talking of science, art, and the various phases of his medical career. The strong, sensitive mouth and shapely nose bespeak a man of refined tastes and thoughts. His large, expressive gray eyes reveal every mood, yet are so kind that I have never seen a child who could resist his overtures of friendship.

He is loved and respected by every one of his patients and assistants. A great operator is not always so kind and thoughtful of the feelings of others. I never heard an assistant receive a rebuff while associated with him in Vienna. He is most genial and informal, meeting subordinates on terms of perfect equality, listening to their various plans and giving latitude for investigation. I shall long remember the hearty handshake he gave me, and the little play as to whether my German or his English was the better, when I first met him, in January of 1902, after his return from a recuperating vacation in northern Africa, and shall never forget the advantages extended to an orthopedic pilgrim.

With all his kindness and courtesy, he is yet tenacious and aggressive when convinced of his position, speaking in his native German with tact, eloquence, and force that carry conviction to hearers. More than once all his strength has been tested in the medical congresses of Europe.

Dr. Lorenz was born in a small town of northern Austria, forty-eight years ago. His father was a watchmaker.

In 1875 he entered the University of Vienna, which has long been the Mecca of the ambitious sons of Austria, and by diligence succeeded in winning an endowed scholarship. By this means, and the small sums earned by tutoring in good families, he eked out the student's life. I am told that frequently bare necessities were luxuries. His clothes were shabby. The old clerk who paid the endowments avers that Lorenz always stood first in line to receive his allowance.

He graduated in medicine in 1880, and obtained the position of clinical assistant to Professor Albert, who then occupied a chair of surgery at the University. In time they became fast friends. Lorenz intended to become a general

surgeon. This was in the early days of antiseptic surgery, introduced by the great English surgeon Lister. All sterilization and cleansing of instruments and hands was done by strong carbolic acid and bichloride solution. He soon experienced a severe poisoning of his hands from the use of these drugs, and found that he had an idiosyncrasy for their poisonous effects. He was in despair, feeling that all his preparation for surgery had been wasted. His friend Professor Albert advised him to take up the specialty of orthopedic surgery, which was comparatively new and unworked in Vienna at that time, and the practice of which then required little cutting. In fact, it was mostly bracing and exercise.

With many forebodings, and feeling that his future had been lost to him by this accidental idiosyncrasy, he commenced to apply himself to orthopedic surgery, continuing to work with Professor Albert.

Still he was poor-very poor-when he met the lady who was to become his wife, in a good family of Vienna. Believing in themselves, they were married in 1884. Mrs. Lorenz, "die Frau Professor," as she is called by patients, a handsome woman of strong and vigorous character, has proved a rare helpmate. While supervising two homes, one in town and another in the country, she finds time to superintend much of the after-treatment of patients, in massage and gymnastics, sees that the Professor takes his meals, reminds him of his appointments, sends him off on vacations when he is overworked, besides looking after much of his correspondence, for Professor Lorenz, like many German doctors, has not yet adopted the laborsaving stenographer. That voluminous book of four hundred pages, describing the congenital hip and its treatment, was all dictated to Mrs. Lorenz on the train while going to and from his suburban home.

Some twelve years ago Professor Hoffa, an orthopedic surgeon, then of Würzburg, now of Berlin, carried out the idea of treating congenital dislocation of the hip by means of cutting the shortened muscles, gouging out deeper the deformed.

1 The word orthopedia is from two Greek words, orthos, straight, and pais, a child. It is generally applied to that branch of surgery which includes the treatment of dedeformities complicating disease or accident. formities, acquired or congenital, and the prevention of

socket, and placing the head of the thigh bone in its proper relation to the body.

Professor Lorenz, after performing one or two operations after this method, found it so sanguinary that he decided never to do another. He developed the idea of stretching and parting the muscles, reducing the dislocated head into the old socket by much less cutting than in the Hoffa operation. After encountering much opposition, his modification was generally accepted throughout Europe, and was called the Hoffa-Lorenz operation.

About 1892, after performing some two hundred of these "open operations," Lorenz conceived the idea of reducing the congenitally dislocated hip by means of manipulation. A child three years old, suffering from this deformity, was given an anæsthetic. After some moments of manipulation, the head of the bone was placed in the socket with a distinct click and shock, both felt and heard by the operator and his assistants.

Paci, of Italy, attempted a reduction in an adult; his manipulations were quite different, and the position in which he fixed the limb was altogether different. It was for some time a much-mooted point as to which had originated the idea of the bloodless reduction; but this has been amicably settled between the professors. Lorenz says that research reveals that a surgeon of Boston conceived the idea years ago, his endeavor to reduce failing, it may be, because of not using an anæsthetic.

In 1895 Professor Lorenz demonstrated his bloodless reduction to the Medical Congress at Berlin. Since 1900 the bloodless operation has been accepted by European surgeons almost to a man. Professor Hoffa still uses the open method on older patients, or when difficulty is experienced in reduction by the bloodless. method.

Professor Lorenz says, with something of reserve-more in his voice than his words that he does not expect ever to find it necessary or advisable to perform the open operation.

He tells me that for several years he accepted no fees for his bloodless operations, telling his patients that it was yet an experiment. If he succeeded in curing them, he expected them to pay well, but should it prove a failure, he wanted nothing. He has demonstrated his operation

in St. Petersburg, Moscow, Constantinople, Cairo, Alexandria, Stockholm, in fact in nearly every large city of Europe except in England.

Professor Lorenz might be said to be a specialist in this one operation, having operated more than one thousand times, and derived more recompense for his labor than from all his other practice.

This is not his only bloodless operation. He has originated operations to straighten club-feet, and limbs contracted by paralysis and inflammation, besides inventing several instruments very useful to the orthopedic surgeon.

He is a voluminous writer, having covered well the subject of his specialty. His German style is admitted to be classical in its simplicity, clearness, and force. He speaks German, French, Italian, English. He is an ardent lover of good pictures and statuary, and has a small fortune in rare paintings. In Vienna, in the pri vate sanatarium, after the strain of operations was over, pictures and art topics were subjects of animated conversation. He loves nature also, and delights in long walks through the forests around Vienna. He is also fond of horseback-riding and tennis.

He looks forward to the time when he may retire to his comfortable country home, leaving the hard work of the profession to the younger men. He has no desire to accumulate an immense fortune, but only a sufficient amount to provide him with a competent income in his retirement. He believes that a man should combine business and recreation. He thinks that he has worked too hard himself, and believes that the American professional and business man does not get what he should out of life.

I was surprised and disappointed to find that orthopedic surgery, with the exception of congenital hip dislocation and club-feet, had always been distasteful drudgery to him. In fact, he has always felt that he should have been a general

drudgery to him.

surgeon.

He lives eight months in the year on the southern bank of the blue Danube, in the little village of Altenberg-Greifenstein, twelve miles west of Vienna, residing in the city during the cold months of winter.

Every morning he rises at 6:30, breakfasts, and catches the train for the city,

accompanied by Mrs. Lorenz. Reaching the city at 8, he drives rapidly to the sanitarium, where private operations are performed. Finishing there, he is driven to the clinic at the University, remaining from 9:30 to 11, and then goes to his city home and office to see private patients until 1, when luncheon is served. From 3 to 5:30, during three days in the week, he attends to the after-treatment and class in gymnastics, returning to his suburban residence at six o'clock.

The influence of Professor Lorenz's visit to this country will be beneficial to both the public and the profession. The orthopedic surgeon will have a better understanding of this bloodless operation and the technique of bandaging and aftertreatment necessary to successful management of these cases. The general practitioner will make an earlier diagnosis of these conditions, which can be cured by the bloodless operation only in infancy and early youth. Many came to us in Chicago who were beyond the age-limit. Professor Lorenz remarked that should he come to America in ten years he hoped not to find these neglected cases.

The laity will be educated to realize the importance of this early treatment, and be directed to the men practicing this specialty of orthopedic surgery, who only can be expected to conduct these cases to a successful cure.

Another condition must be faced and

understood by the public and profession. Many will be disappointed, since Professor Lorenz, with his great experience and skill, cannot warrant all cases. Fifty per cent. of all cases in his practice have been cured, while the other fifty per cent. have been only ameliorated.

Still, the operation will be eagerly attempted by over-confident, inefficient men, who have only seen the work from the arena, who comprehend nothing of the minutia of the complete reduction, the deepening of the socket, and the elimina tion of the forces tending to relaxation; who know nothing of the position of stability in the different deformities, the holding of the limb in this position by the application of plaster of Paris, yet permitting the joint to functionate, giving Nature an opportunity to adjust the tissues and insure the stability of the new condition; who never saw the sometimes so necessary and long after-treatment, considered of no secondary importance by the Professor, requiring experience and knowledge of the anatomical relations that cannot be learned from books.

And yet another phase. The laity may become the credulous prey of various advertising institutions, self-styled specialists, imitators, and wonder-workers, such as one I read of in Chicago, who claimed that he had reduced a congenital dislocation in an adult, without anæsthetics, by massage and traction.

W

ITH the exception of Bermuda and Gibraltar, the Island of Hongkong is the smallest colony in the British Empire, but in more than one respect it is the most interesting. Its area is less than thirty square miles; its population is equal to that of Washington (300,000); yet in the year 1900 Hongkong stood at the head of all ports of the world in the magnitude of its shipping. In tonnage entered and cleared in 1900 Hongkong surpassed Liverpool by five million tons, Hamburg by one million, London and New York by about half a million tons each. The exact figures were:

These figures appear the more remarkable if we consider the history of Hong kong. The island was ceded to England by China in 1842 by the Treaty of Nanking. At that time the population of the colony was about 5,000, made up of pirates, fishermen, farmers, and graniteworkers, living in huts made of bakedmud bricks, and holding no intercourse with the outside world beyond Canton, which lies ninety miles to the north.

This was sixty years ago, and to-day Hongkong has a population of 300,000 souls, a fine city for its capital, splendid

roads, schools, churches, banks, hospitals, clubs, hotels, newspapers, electric light, cable cars-in short, almost everything which we are accustomed to associate with

the idea of an advanced civilizationwhile it is connected with the outside while it is connected with the outside world by cable and by the most extensive

1 In this article the New Territory, a tract of land recently leased from China and placed under the government of Hongkong, is not included.

system of steamship lines which converge at any single port in the world.

The transformation of Hongkong forms one of the most striking chapters in the history of the white man's work in the tropics. It has not been accomplished without the commission of many grave errors of policy, due for the most part to the persistent refusal of the British Government to be guided by the views of the man on the spot; nor can it be said that even to-day the interests of the colony are free from danger from the same cause; but the record, on the whole, has been one of brilliant success, and the administration of Hongkong, though by no means free from faults, is a valuable object-lesson in the management of a Chinese community on Western lines.

Pursuing the method of inquiry which was indicated in the first article of this series (see The Outlook for November 22), our first task is to consider the fixed con

ditions which prevail in Hongkong from the nature of the climate, the people, and

the land.

The composition of the population of Hongkong has been determined by two

causes- -the climate and the situation of the island. The first of these, acting as a general factor, made it inevitable that the mass of the population should be of a colored race, for in no part of the tropics can manual labor be performed by white men, and it has always been found that, in places where the laboring classes are composed of colored men, only the very highest occupations will be taken up by white men. A natural limit is thus set to the proportion of white men which can be supported by any community in the tropics. The second cause, acting as a specific factor, assigned to Hongkong a Chinese population; for if the climate predetermined a colored race, the situa

tion of the island on the threshold of China decided which race it was to be.

The census returns of 1901 disclose the precise effects of these causes :

CIVIL POPULATION OF HONGKONG IN 1901 Europeans and Americans, 6,454, equal to 2 27 per cent. Chinese. 274,543 96.68 Others..... 64 2,978 1.05 It is clear that for a colony with such a population any form of government which involves a general representation of the taxpayers is impossible, for less than two per cent. of the taxpayers are British subjects, and more than ninety-five per cent. are Chinese.

In the long experience of England in governing colonies, a form of government has been evolved to meet the case of a colony in which the population is made up of a handful of temporary residents belonging to the ruling race and an overwhelming number of natives. This is known as Crown Colony government. Its essential feature is the entire absence of any popular element in the administration, and the direct control exercised by the Colonial Office in London over all acts of the local authorities; the theory on which it is based is this, that, whereas a representative government in Hongkong which rested on a general franchise would place the British residents under the heel of the Chinese, a franchise which extended only to white British subjects would put the mass of the population and the great majority of the taxpayers at the mercy of a handful of merchants, and that under such circumstances the best way to secure honest and efficient administration is to place the control of affairs in the hands of a distant body of trained officials.

The Government of Hongkong consists of the Governor, the Executive Council, and the Legislative Council. The Governor is appointed by the Crown, and holds his office for five years. The Executive Council consists of six official and two unofficial members, presided over by the Governor. Of the six official members five hold their seats ex officio-namely, the gentlemen holding the offices of Senior Military Officer, Attorney-General, Colonial Secretary, Director of Public Works, and Colonial Treasurer. The sixth official member is the Harbormaster, who holds his seat by appointment. The two

unofficial members are appointed by the Crown, through the Secretary of State for the Colonies. The meetings of the Executive Council are not open to the public; but minutes are kept, one copy of which is filed in the colony, and one in the Colonial Office in London. The work of the Executive Council covers a very wide range of subjects. The ordinary business may be divided into seven classes: 1. Any matter in which the Governor requires special advice as, for instance, when the heads of two departments of the Government differ in regard to some proposed measure which affects both departments. 2. The granting of leave of absence on half-pay to officials. 3. The dismissal of public servants. 4. The discussion of such legislative measures as it is proposed to lay before the Legislative Council. 5. The consideration of cases in which a capital sentence has been pronounced on a criminal by the Supreme Court. 6. The reading of such confidential despatches from the Secretary of State for the Colonies as the Governor may deem proper to lay before the Council. 7. The making of regulations by the Governor-in-Council, as provided by law, on such subjects as quarantine, opium licenses, sanitary by-laws, and so on.

Of the

The Legislative Council of Hongkong consists of seven official and six unofficial members, presided over by the Governor, who has an original and a casting vote. Of the official members five are those who have seats in the Executive Council, and the other two are appointed. unofficial members one is nominated by the Hongkong Chamber of Commerce, and one by the Justices of the Peace of the colony; the remaining four are appointed by the Crown, and of these one at least must be a Chinaman. Members of the Legislative Council hold their seats for six years, and are eligible for reappoint

ment.

The most important duty of the Legislative Council is to pass the laws of the colony. Any member may introduce a bill; but any bill, vote, or resolution, the object or effect of which may be to dispose of or charge any part of the revenue of the colony, can be proposed only by the Governor or with his express consent. The annual estimates are discussed by the Legislative Council, and without its