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.

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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