Meanwhile the Sanitary Service was subjected to much severe and exaggerated criticism, owing to the refusal of the authorities to accept assistance from outside. The attitude of the "Médecin d'Armée" vis-à-vis of the aid offered by the Red Cross organizations of the Allies with regard to the supply of nurses, masseurs, etc., was influenced in no small measure by the decisive stand taken by Swiss Trade Unions, who were jealously opposed to the employment of foreign labour to the detriment of the Swiss worker. He was obliged to give due consideration to popular opinion on the subject, and to follow the lead of his Government, so that in many cases the acceptance or non-acceptance of the assistance offered was determined for him, and not by him. I may safely assert that his decisions were never inspired by personal prejudice, or based on a narrow or jealous view.

As regards Mürren, no local hospital being available, cases requiring any special treatment were sent to the District Hospital at Interlaken, or to the hospitals at Berne, Lucerne, and Fribourg. Two small wards were set aside in one of the hotels for patients suffering from ordinary ailments, and a good deal of medical work was carried out in the hotels, sun cures being much in favour for the treatment of open wounds, etc. For massage and orthopædic exercises a gymnasium was installed, with apparatus of a useful kind. We were indebted to the generosity of a Swiss friend for certain of the more delicate and costly pieces for vibratory exercises. The equipment consisted of twenty-five apparatuses for "mécanothérapie," two for "faradization," and one for "galvanization." During 1916 above 253 cases were treated, of which 96 were by massage, 45 by "électrothérapie," and 112 by "mécanothérapie"; 180 men were subjected to sun cures.

A description of the District Hospital of Interlaken, where so much work was done for us, will serve to illustrate the general type of civil hospitals placed at the disposal of the general public all over Switzerland. This hospital is divided into wards of five to ten beds, affording accommodation for some 150 patients. The personnel consists of a resident surgeon with a staff of doctors capable of dealing with all the ordinary work of the district. The surgeon in charge had served his novitiate under Professor Kocher, of Berne, and was well known throughout the length and breadth of the Bernese Oberland as a very skilful operator.

I may here call attention to a marked feature of the civil work in Switzerland, in that many of the most promising young surgeons and practitioners of the country, after their early years of study and association with such masters of their art as Professors Kocher and Roux, take up their life-work in the smaller towns, where they build up a reputation in their turn, second only to that of their erstwhile masters. The peasants and the general public have, therefore, at their very doors, up and down the country side, specialists of a high order of professional skill. Perhaps in no country in the world are there specialists so widely distributed as in Switzerland, much to the advantage and well-being of the people. These doctors live hard and frugal lives, and give their services for fees which in our country would be considered derisory; but they lend lustre to a Sanitary Service which is held in high esteem by their countrymen, and which is the admiration of the foreigner within their gates.

Before concluding this account of the sanitary organization of Mürren, I must add a word regarding an important branch of that work inaugurated at the "Manor Farm." This châlet, the property of an English lady, Miss Simpkin, served in pre-war days as a pension for British and American visitors. It was beautifully situated, two kilometres from Interlaken, on the shore of the Lake of Thoune, and Miss Simpkin conceived the happy thought of offering it to the medical authorities as a convalescent home for soldiers suffering from neurasthenia, shell shock, heart, etc. The offer was gladly accepted. Twenty officers and men were in constant residence there, and it would be difficult to exaggerate the care and kindness lavished on them by this devoted lady.

Apart from the treatment afforded by the ordinary camp organizations, with their associated hospitals as already described, the principle was adopted of utilizing, so far as practicable, the services of specialists in such centres as Berne, Fribourg, Lausanne, Montreux, Geneva, etc. We thus find many of the best-known professors and doctors of Switzerland, some of whom have a world-wide reputation, actively engaged in their own hospitals in the service of the Interned.

A special Sanitary Establishment was also created by the "Médecin d'Armée" at Lucerne, in June, 1916, with 190 beds and a staff of eleven doctors, known as the "Armée-Sanitäts-Anstalt," destined for the common use of the Interned of all nations for operative work in connection with bone-grafting, tendon-transplantation, brain and nerve surgery, and complicated plastic movements. The beds were distributed as follows: 6 to officers, and 78 to French, 22 to British, and 84 to German N.C.Os. and men, the different nationalities being accommodated in different wards. This hospital was well equipped from a scientific point of view, and was supplemented by annexes to which the convalescents were transferred. The annexe set aside for the British was the congeries of châlets at Seebourg, four kilometres from Lucerne, owned by the London Polytechnic Society. This was kindly placed at my disposal by the Society, and was further utilized for the accommodation of men attending the classes for technical instruction established under the auspices of the B.R.C.S., London. The "A.S.A.," however, proving unequal to the ever-increasing strain, had to be supplemented on September 8, 1916, by the addition at the "Clinique Générale," Geneva, under the direction of Dr. Julliard, of a service for the treatment of lesions of the jaw and face. Another service was also opened by Dr. Machard, at Geneva, and a third by Dr. Matti, at the Salem Hospital, at Berne, also for lesions of the face and jaw.

The specialization demanded was in this way gradually placed at the service of the Interned, but its creation was not the outcome of a day. The year 1916 was a transition period of trial and evolution, during which many mistakes were made, but which ended in the development of an efficient organization capable of meeting all demands. That the Swiss Sanitary Service, both in its military and civil branches, should have met so readily demands of so unprecedented a nature, shows a remarkable spirit of originality and adaptability, which is deserving of record and acknowledgment.

One other special establishment, set apart in 1917 for the use of the Allies, was that of the Fribourg Hospital. Early in that year I received a visit from the Comtesse de Zürich de Reynolds, informing me of a scheme initiated by herself and the Baronne de Montenach, both residents of Fribourg, for the equipment of a large hospital on the outskirts of the town, built originally by the municipality as a Maternity Hospital, but which for financial reasons had never been opened as such. The municipal authorities had expressed their willingness to hand over the building as a Military Hospital dedicated to the use of the Allies for the period of the war, and funds were being collected with the intention of transferring it, after equipment, to the "Médecin d'Armée." The hospital was calculated to provide beds for about 120 officers and men, at a cost originally estimated at frs. 100,000. Of this sum, frs. 75,000 had already been promised, by French Red Cross sources, to Mme. de Montenach, who was devoting herself more especially to the Franco-Belgian side of the question.