Billeder på siden
PDF
ePub

the autumn, a preliminary course is given upon Microscopy, Regional Anatomy, Physical Diagnosis, Diseases of the Skin, and Morbid Anatomy. At the Jefferson College, the course is strictly practical, embracing important specialties in medicine and surgery, with extensive clinical illustrations, as Clinical Surgery, Clinical Obstetrics, Medical Jurisprudence and Toxicology, Materia Medica and Therapeutics, Clinical Medicine, Visceral and Surgical Anatomy, Operative and Minor Surgery, Operative and Aural Surgery, Venereal and Cutaneous Diseases, Pathological Anatomy, and Surgical Diseases of the GenitoUrinary Organs.

While on a visit to a friend at Newport, Rhode Island, last October, I had the opportunity of examining the Earth-Closet, the invention of Rev. Henry Moule, of Fordington Vicarge, Dorsetshire, England. My friend, during a recent visit to England, became so fully impressed with their value as substitutes under almost all circumstances, for the ordinary privies and water-closets, that he imported two Commodes. Recently, one of these was sent to this city, and placed, by the direction of Dr. Addinel Hewson, in the lower surgical wards of the Pennsylvania Hospital. In these wards it was used by twenty patients, (the hod is calculated to hold from eighteen to twenty evacuations), and the contents were not removed until evening. Patients in the fracture-beds were each given a paper bag, holding about a pound of dry earth, and were required after using the bed-pan (attached to each fracture-bed), to empty the contents of the bag into the pan. Although the Commode stood in the middle of the ward, surrounded only by a screen, still there was not the slightest odor perceptible.

Col. Geo. E. Waring, of Newport, Rhode Island, in a pamphlet upon the subject, states the principle to be "the power of clay and the decomposed organic matter found in the soil to absorb and retain all offensive odors and all fertilizing matters; and it (the closet) consists, essentially, of a mechanical contrivance (attached to the ordinary seat) for measuring out and discharging into the vault or pan below, a sufficient quantity of sifted dry earth to entirely cover the solid ordure and to absorb the urine."

Reflecting upon this absorbent power of clay, Dr. Hewson was led to use it as a dressing to suppurating wounds, and so satisfactory were the results obtained in these cases, that since February 9th, every case, no matter of what character, has been submitted to the dry earth dressing. Its advantages have been most fully demonstrated in cases of scald and burns, and intractable bed-sores. In the former, when

applied immediately upon receipt of the injury, the pain is at once relieved, and the reparative process goes on rapidly. In the latter, and also in all chronic ulcers, its action is most decided. In one case

of paraplegia, in which there was dribbling of urine, the offensive urinous odor was entirely removed, and the patient made comfortable, by placing a layer of earth, protected by the sheet, beneath the buttocks. The patients speak of it in the highest terms, as a cool and pleasant dressing, and it is by far a cleaner application than those ordinarily employed. The results are truly remarkable, and have been critically examined by Dr. H. His experience thus far, confirms him in the belief that the earth acts not alone mechanically, but chemically that, under its application, chemical action takes place as indicated by the fact that the pus, from the wounds, is found by the litmus paper to be neutral, instead of alkaline, its normal state. May it not act, he suggests, upon the exudations from the tissues so as to prevent alkaline fermentation, and thus prevent the formation of pus?

This subject is of great interest, and its consideration by Dr. Hewson, will furnish an article in the next Pennsylvania Hospital Reports. I observe, by a circular sent me, that an earth-closet company has been established in this country, at Hartford, Connecticut. This will, I hope, secure the speedy introduction into use of this valuable invention. Yours, very truly, J. E. M.

FROM BERLIN TO VIENNA.

VIENNA, JANUARY 8, 1869.

DEAR EDITOR: Almost embowered among a grove of trees at the far end of a broad boulevard that skirts the crumbling old wall which formed her medieval ramparts, stands a handsome, square, stone building of the chaste Doric style, which is known as the University of Halle Saxony. Ascending a broad flight of stone steps, graced on each side by a recumbent statue of a bronze lion, we enter a high, spacious hall, around which in small wire-protected frames the announcements of lectures are posted. Another flight, and we stand upon the level of the various lecture rooms of all the departments of science. Four fluted columns of stone on each side, support the ornamented roof, extending the distance of the second and third stories. The rooms are all small, and furnished simply with the long wooden

benches of our country school houses, and a small pulpit for the lecturer. The hours of lectures are denoted by placards on the various doors, and are so arranged that several departments of science are taught in the same apartment during different hours of the same day; thus discourses on philosophy, medicine, mathematics or theology, may all be delivered in the same room. The clinical instruction always occurs in the hospital building; and except the branches of anatomy, physiology and chemistry, all the branches of medicine in this, as in all the schools of Germany, are taught there. The University of Halle numbers now some seven hundred students in all its departments→→ mostly theologians. The school was founded in 1694, in the old building, and received a considerable accession in 1817 by the transfer of the college at Wittenberg, the scene of Luther's action. The proximity of the city, however, to Leipsic and Berlin, injures it very materially, in its medical advantages, as the celebrities of the profession are always attracted there. Oldhausen is the professor of obstetrics at present; being, however, one of Martin's assistants, it was fair to suppose that his views were mostly imbibitions. And as our haste to Vienna was rendered urgent by the fact that most of the short courses would commence in the following week, we were fain to content ourselves with the above mentioned visit to the University.

We pushed on through Leipsic-only a day for the city and its old University, a long pile of yellow buildings, part of the Augusteum, facing the main square of the city, a hurried glance through its lecture rooms, and its aula, a large saloon of busts and statues of Saxon Princes, with twelve reliefs of the history of education, then a peep into several of the old antiquarian book stores, which only made us lament our limited means, for all the curiosities and relics of literature in all languages are there. Leipsic is the grand center of the book trade in Germany. It has some one hundred and ninety-two book stores, forty printing offices, one hundred and nine hand and one hundred and thirty-nine machine presses. During the Mässe, which are great fairs held three times a year, and which attracts "Armenians, Turks, and dwellers beyond Jordan," book dealers from all civilized lands visit the city for purchase and sale. A few years ago they erected their own exchange, which is now their business resort.

Two days travel on a rather circuitous route, carries us into Würzberg, one of the wealthy cities of the little kingdom of Bavaria, whither we have come to see and hear Scanzoni. Most of the public buildings of the city were erected at a time when Würzberg was a free

city, the capital of an episcopal see, which position it held upwards of a thousand years, under the successive jurisdiction of some eighty-two bishops. Hence the buildings have been erected with that lavishment of means which the very large revenues of such positions permit. The hospital is an immense structure, covering more than two solid squares, inclusive of the medical college in its rear. The endowment of the whole institution is some two and a half million dollars in gold; it contains about six hundred inmates, of whom not more than onehalf are patients; a large, handsome bronze statue of Julius Echter, its founder, one of the city's primates towards the latter part of the sixteenth century, stands at the front. The appointments of the whole building are even much finer than those of the Charité of Berlin. The consequence of this rich endowment, is the security of a magnificent faculty, for which this institution has always been famous. Kölliker on microscopic anatomy, Bamberger on internal medicine, Recklinghausen on pathology, and Scanzoni on obstetrics, are among the most famous. The lying-in hospital stands apart from the main building, forming a neat, rather small two story stuccoed building, with accommodations for about fifty cases, which is a fair allowance for a city of only forty thousand inhabitants. By the kindness of Dr. Mundi, Prof. Scanzoni's first assistant, we were permitted to visit the building and make the rounds with him. Patients are divided into first, second and third classes, according to their means, the latter class being charity patients, and private apartments are furnished for those sad cases in the upper circles in which "a child is found for the cradle before a husband for the bed." Except one or two cases of pelvic abscess, the wards were remarkably free from disease of any character on our visit, much to our wonder, for every window throughout was as hermetically sealed as the general German hygiene in practice demands-the peculiar puerperal odor was actually sickening. The immunity of disease under such conditions can only be explained on the thorough habituation from infancy on, and the intense aversion every son of Teutonia cherishes against a draught. The babies were all bundled and rolled, and their little arms tied down inside, so that they could be lifted by any one of half a dozen bands and tossed about like a papoose with perfect impunity. The delivery bed was elevated at the back to such an extent as to cause the assumption of a semi-recumbent posture in labor, resembling no little some of the old Gebär Stühle or delivery chairs, which were so common in Germany fifty or sixty years ago, and which are now universally discarded. The lec

ture room contains a very fine array of instruments and a valuable collection of deformed pelves; the original Robert's pelvis, in which the transverse diameter was contracted to two inches, while the conjugate remains normal, being among the number. Among the novelties may be mentioned a peculiar cephalotribe, an invention of Scanzoni's, which merits a description. In addition to the two blades of the ordinary cephalotribe, the instrument was provided with a perforator, whose extremity was a pointed ovoid of perhaps an inch in diameter, the outer surface grooved or threaded like a screw; after the cephalotribe is applied in the usual manner, the perforator is passed between the handles, thrust through the cranium or fontanelle, as the case may be, and then carried on through the brain until its point lodges in the foramen magnum, several turns of the handle screw it into the foramen, when the handle of the perforator is attached to the handles of the cephalotribe by a clamp. The advantage claimed for it is solidity of grasp; the attachment at the base of the head and in its most unyielding bone, even into the commencement of the spinal canal, will not permit it to glide. We were informed that on the manikin the instrument worked charmingly; an opportunity for its application in utero had not, as yet, presented. The only objection that occurred to us, would be the adjustment of the machine, for its complicated character certainly entitles it to that name. A finger, provided with the educated obstetrical eye, might recognize the foramen, if it could reach it; but the ocularisation (?) if of the end of a twelve inch steel rod, would imply a delicacy of tactile sensibility in the hands of the manipulator, that it would require an eye of faith to take cognizance thereof. We do wrong, however, in attempting a jest on a scientific subject. If the pointed end could be fastened into the occipital bone anywhere, it is probable that it would answer the purpose. Scanzoni, himself, is a type of a gentleman and a scholar, and we could not avoid contrasting him in this light with some of his numerous detractors, who all suffer by the comparison. In person, rather portly, now that he is verging on to his sixth decade, with a genial, placid face, pleasant to look upon and that feels at peace with itself and mankind, a clear, rather full eye, beneath a lid with that redundancy of tissue which the physiognomists tell us is a sign of decision, never dull or slow of comprehension, for it shoots a quick glance out of its angles occasionally, which takes cognizance of things which are not always mentioned; in manner affable, courteous, more, even inviting, delivery easy, elegant, chaste; as he leaned on the bed, with one hand in gesture over it and one slipped

« ForrigeFortsæt »