849

The medical officers of the asylum stated that they knew everysymptom in the cases, and that at the time of entry of thepatients into the asylum they are carefully examined, and onturning up their registered number details of their case canbe found. Unfortunately, owing to the transfer to the newbuildings at Purdysburn, the notes of one of the cases weredelayed in their production. It would seem that the notes ofthe best cases are kept, and the inspectors suggest that thisshould apply to all the cases. The medical officers think thatwith 800 patients to look after to make a record of every oneof these day by day would not be possible. If this is so,probably the best way out of the difficulty would be toincrease the staff. The finding of the inspectors is a com-

plete answer to the coroners’ juries, and its value is increasedby the report of the inspector (Mr. Courtney), who visitedthe lunatic department of the Belfast Workhouse on

Aug. 7th, and who states that ’’ the accommodation pro-vided here [Belfast Union Workhouse, lunatic department]is certainly on a much more liberal scale than that set apartfor the use of the lunatic and imbecile inmates in any otherworkhouse in Ireland." This report of the Inspector ofLunatics was read at a meeting of the Belfast board ofguardians on Sept. 8th.

The Cork TVomen and Children’s Hospital.Considerable structural improvements were recently made

in the Cork Women and Children’s Hospital, and as the com-mittee found they had incurred a debt of 2000 they decidedon making an effort to relieve their financial embarrassment.Accordingly they took steps for holding a very extensivebazaar called "Wonderland." There was quite a variedprogramme of entertainment and the initial expenses aloneamounted to £1000. His Excellency the Lord-Lieutenantgraciously signified his intention of opening the bazaar, and,accompanied by the Countess Cadogan, he performed the cere-mony in the presence of a very fashionable attendance. His

Excellency in an appropriate speech expressed his sympathyand that of the Countess with the objects of the charity;and as politicians of every varied shade of thought regardhis Excellency as a nobleman who takes a lively interest inthe general welfare of the country his patronage tendedmaterially to promote the success of the bazaar. Thoughthe weather was somewhat unpropitious quite a throng ofpeople attended, especially at night, and it is generally ex-pected that the net result will be the addition of a consider-able sum to the resources of the institution.

Contributions by the Royal Irish Constabulary to MedicalCharities.

The Royal Irish Constabulary stationed at Cork con-tributed to the entertainment of the citizens by organising avery successful meeting for athletic sports in the park. A

special feature of the day was the presence of the excellentband of the Constabulary from the depôt. The attendancewas very large, and after paying expenses the promotersfound that they had a sum of C305 to dispose of. Theyallocated it as follows :-Widows’ and Orphans’ Fund of theForce, £100 ; North Infirmary, .E25; South Infirmary, Q25 ;Women and Children’s Hospital, .625 ; Eye, Ear, and ThroatHospital, E25; Mercy Hospital, e25; Fever Hospital, E20;’St. Vincent’s Hospital, .620 ; Protestant Incurable Hospital,£20 ; and St. Patrick’s Incurable Hospital, £20. The Con-stabulary are to be congratulated, not alone on the success ofthe athletic meeting they inaugurated, but also on the

generosity they displayed towards the local medical charities.Sapt. 16th.

________________

ROME.(FROM OUR OWN CORRESPONDENT.)

Professor Palmieri.THE science or sciences that deal with the earth’s crust

:n movement and repose have lost a very able votary inthe Director of the Vesuvian Observatory, Professor LuigiPalmieri, who died on the 9th inst., aged sixty-nine years.In seismology, the honour of developing and systematisingwhich he shares with the late Padre Denza, of the VaticanObservatory, and the Count Michele di Rossi, he was anacknowledged master; while in meteorology and climatologyhe contributed greatly to their preciser and wider knowledgeby numerous papers in that mine of industry and research,the " Annali dell’ Osservatorio Vesuviano." Not only on thetheoretical side of these subjects did he evolve many

ingenious and suggestive ideas, but as a practical worker headded more than one valuable instrument to the scientificarmoury-notably his "electrometer for the observation ofatmospheric electricity," his "pluviometer" (or rain gauge),his "seismometer," and suchlike. Such a revolutiondid he effect in the domain of terrestrial physics thatin his hands it became almost a new science, in recognitionof which the University of Naples founded a chair for its

teaching and made him its first professor, while at the sametime he was appointed Director of the Physical Observatoryin that city. A first-rate mathematician, his training inexact science formed an admirable prelude to his physicaland natural history studies, and (such was his many-sidedcapacity) he was able to lecture ad interim on moral andmetaphysical philosophy when Baron Galluppi, the dis-

tinguished interpreter of Kant to his compatriots, ceased tohold that chair. But his real post was at the Observatoryon Mount Vesuvius, whose eruptions he described withscientific lucidity and classic elegance, and all of which forthe last forty-two years he personally witnessed, often, asin the memorable one in 1872, at the risk of encounteringthe fate of the Elder Pliny. He was courtesy and kindnessitself to English-speaking visitors-to none more than tothose of the medical profession, as can be attested by nota few who explored the Neapolitan Riviera after the Inter-national Congress of Medicine and Surgery held at Rome inthe Easter of 1894.

Getting Rich by Degrees."Three years ago the sale of bogus degrees had reached pro-

portions in Bologna which incurred the intervention of thepolice, and their manufacturer is still, I believe, serving histime in one of the local prisons. But the summary examplemade of him has not, it would appear, proved much of adeterrent. At least, from information gathered in Italythe "industry" is still a paying one, if the number of" graduates" whose scholastic record is rather dim may bereceived as a test. This time the University which confersthe " summi in medicina honores " is not Bologna, but Berne,whose "sigillum magnum " was stolen, or in some way gotat, so as to be counterfeited to perfection. The allegedthief or forger has been arrested, but the corpus delictiwas not found in his possession and is still to seek.So the world is not yet safe against the illicit creationof graduates (medical and other, but chiefly medical), ofwhom, it seems, there are already about 250 vaunting them-selves "laureati" of the leading Swiss University! Scan-dinavia and Germany boast the majority of such graduates,"while there are some fifty or so practising in (or on ") theEnglish-speaking public in both hemispheres. The rest arechiefly to be found in Italy, Austria, and the East.

Mushroom Poisoning.Italy is greatly in want of a handy book or chart indicating

the edible and non-edible fungi. So far as I know shepossesses nothing like that excellent descriptive treatiseon the subject compiled by Mr. Plowright and noticed inTHE LANCET of Feb. 25th, 1893. The consequence isthat even among the educated middle classes the con-sumption of poisonous mushrooms is of frequent, oftenof fatal, occurrence, as, indeed, a glance at any urbanor provincial Italian newspaper will suffice to show. I

open one of these and find that at Cadignano, in theBrescian province, a respectable family, nine in number,has just lost seven of its members by the ingestion ofmushrooms belonging to the variety called ovolus "

in Italian classification, and resembling in size and forma hen’s egg. The tenesmi preceding the death of thevictims are described as " agonising," the stomach-pump having been applied too late, and the usualremedies (emetics, catharto-emetics, demulcent draughts,and ether in strong doses) proving inert or inefficacious.I turn to another paper and read, this time in

Piedmont, of a family consisting of father, mother,and four children, ranging from six to eleven yearsof age, and an uncle of these having eaten heartily of mush-rooms and, not till some days afterwards, succumbing totheir effects. Grave intestinal disturbance, increasing as tointensity, followed the meal, till first the children died, thenthe uncle, and only the parents (thanks to constitutions

exceptionally robust) survived. The necropsy proved thecause of death to have been "mushroom poisoning," but

the description of the fungi is not given. In the large cities(Rome. Florence, Naples, and Milan, for example) the sani-tary officers continually impound unwholesome mushrooms

850

exposed for sale, but those which caused the tragedies above referred to had been freshly gathered. Another lwarning to the British tourist in Italy when wandering outof the beaten (that is, the civilised) path to be very carefulof what he eats at village osterie or mountain inns.

Sept. 12th, 1896.. ________________

VIENNA.(FROM OUR OWN CORRESPONDENT.)

Medical Study in Austria. t

MEDICAL study and life are so different in England andAustria that it will perhaps be of interest to the readers ofTHE LANCET to know how their Austrian colleagues areeducated, how they pass their student career, and whatexaminations they have to undergo. At the age of ten yearsthe boys intended to become university students commencetheir general education in a State-supported school called agymnasium, where not much attention is given to eithernatural history, physics, or chemistry. After an eight years’course the youth has to pass the Reifepriifung-a severe 9examination, at which the Government is representedby a commissioner-and he is then at liberty to enterthe University and to decide which faculty he will join onshowing his certificate and paying his matriculation fee of10s. Medical study in Austria lasts five years ; during thistime the student has to attend classes in medicine andsurgery four half-years each, and classes in anatomy,obstetrics, and ophthalmology one half-year each. Lectmesare delivered five times a week : for those which last onehour there is a fixed fee of 10s. 5d. a half-year. There arepreliminary examinations in zoology, mineralogy, andbotany, which may be passed during the first half-year,the fees for each of these three subjects amounting to 12s.,or £1 16s. in all. After the lapse of two years the studentis admitted to the first Rigorosuna, an examination whichconsists of a practical and an oral part, the former portioncomprising anatomy and physiology, and the latter includinganatomy, physiology, chemistry, and physics. The fee forthe whole examination is £4 12s. Candidates rejected in apractical examination must wait four months; those whofail in one subject of the oral examination must wait twomonths, and those who fail in two subjects have to repeatthe whole examination. The student is admitted to thesecond and third examinations (which are called the secondand third Rigorosum) only after five years, when he is in

possession of the so-called Absolutorium, wherein is testifiedthat he has attended the above classes. The fees forthe second and third examinations amount to .65 and E5 8s.respectively. The practical part of the second examina-tion comprises internal medicine and pathological anatomy.In the former subject the candidate has to describe the con-dition of the patient and the results of auscultation and

percussion; he has also to diagnose the nature of the case andprescribe appropriate treatment. Pathological anatomy hasnow become one of the most difficult subjects of examination,for according to the new regulations an extensive knowledgeof pathological histology will be required. The theoreticalpart of the second examination is taken up with pathologicalanatomy, internal medicine, pharmacology, and experimentalpathology ; there are also additional examiners in diseases ofchildren, laryngology, or otology. The third examinationconsists of practical examinations in surgery, obstetrics, andophthalmology, and theoretical examinations in these threesubjects and in forensic medicine ; there are also additionalexaminers in either syphilis or dermatology. After having ’,passed this examination the student obtains his diplomaof M.D., for which he has to pay £5 6s. Thereare thus four medical examinations-namely, the pre-liminary, and the first, second, and third Rigorosum.Although the teachers are excellent and the examinationssearching the new-made M.D, is deficient in practical know-ledge. He has, indeed, while a student witnessed thevarious stages of making a diagnosis and has seen a greatmany operations performed, but he has not been permittedto approach the patient himself and his practical traininghas still to be acquired, for which purpose he enters a clinicas assistant physician. In the department of practice ofmedicine there is no difficulty in obtaining such an appoint-ment, but, on the other hand, there are only a few menwho are fortunate enough to become so-called "operatingaspirants" in a surgical or obstetrical clinic, while theirless favoured brethren have to attend practical courses

in order to extend their knowledge of those two subjects.The period that elapses from a young man’s entering theuniversity until he starts in practice is, as a rule, eight years.Many students, however, become inattentive to their workand drift into "Bphemianism," either from the influence ofthe various convivial associations or through financial diffi-culties. Of the students’ associations a great many arepurely Teutonic, some are Slav, and some are Jewish ; duringthe last two years some students have joined the first Viennafootball and cricket club. Living in Vienna is not expensive;for many years there has been a mensa Academica, wherepoor students are provided with dinner free of charge, whilethose who are better off have to pay 18s. a month for dinnerand supper.

BUDAPEST.(FROM OUR OWN CORRESPONDENT.)

Influenza and the Female Organism.THE last issue of the Orvosi Hetilap contains an interest-

ing communication by Professor G. Engel of Kolozsvar onInfluenza and the Female Organism. We know clinicallyfour types of influenza-viz., the febrile, the nervous, thecatarrhal, and the gastric. The two former types were themore commonly observed in women. It is to be noted thatthe disease not infrequently attacked the female generativeorgans. In addition to an increased loss of blood duringthe menstrual period and sometimes marked sensibilityalong the uterine appendages, there was also a con-

siderable aggravation of the symptoms in cases of pre-existing acute or chronic inflammations of the womb. Theeffect of influenza on pregnancy was very unfavourable.Professor Engel knows of no other infectious disease whichso often causes premature expulsion of the ovum as

influenza. He observed miscarriage most frequently in thefirst three months of gestation. In cases where pregnancywent to full term the duration of labour was prolonged andthe involution of the uterus was retarded. Influenza afterchildbirth may to some extent simulate puerperal sepsis.

Delivery through a Central Rupture of the Perineum.This case, described by Dr. N. Liszt in a recent number of

the (Gyógyászat, is well worthy of being recorded. Thepatient, a primipara aged twenty years, was at her confine-ment attended by her mother, who was a qualified midwife.According to her statement labour pains came on at mid-night. The time of the rupture of the membranes was

unknown. The next day, at 1.30 P.M., the perineum beganto bulge and two hours later it gave way at its centre, thechild’s left hand prolapsing through the rent. The motherthen sent for medical aid and in the meantime made despe-rate efforts to keep back the protruding fœtal parts. Shedid not succeed, the strong uterine contractions expellingfirst the arm and then successively the trunk, thebreech, and the lower extremities of the chiId (justas in a case of spontaneous evolution). However, she

was " successful " in arresting the progress of the

. after-coming head during an hour and a half until medicalaid arrived. She had kept the child’s head back for fearthat " the bowels might fall out." It was quite easy to

, extract the head. The placenta was expelled through thesame channel. There was no haemorrhage. The child wasat full term, and was dead, as a matter of course. The rent

} in the perineum had the form of an arch, with its convexityL looking backwards. It was situated one centimetre in frontr of the anal opening. The corresponding rent in the posterior

vaginal wall ran vertically downwards from the fornix close> to the fourchette. This and the anus remained intact. The: wound was carefully cleansed and sutured, a small canal. having been left to allow of drainage with iodoform gauze,

and it healed firmly, but a narrow vagino-perineal fistula- remained, which only closed after some applications of a

concentrated solution of nitrate of silver.t Sept. 16th.

______________

1

RUSSIA.(FROM OUR OWN CORRESPONDENT.)

The International Medical Congress : The Section of Surgery.THE foUowing questions will be discussed in the Sectionof Surgery at the International Congress in Moscow next