CORRESPONDENCE. FOREIGN SKETCHES. HAROLD B. WILSON, M. D., Ann Arbor, Mich. Second Paper. STRASSBURG.-HEIDELBERG. The university of Strassburg used to be one of the foremost seats of learning in France, not so very long ago. Now, however, it is denationalized, just as Strassburg and Elsass-Lothringen are, and figures as a part of the domain of Kaiser Wilhelm. The only traces of its former self are found in a course or two delivered by Prof. Aubenas, on obstetrical subjects, wet nursing, or something of that sort, and in some of the old buildings still occupied by portions of the university; such as the Bürger Spital for instance, whose rather rickety, and certainly very old buildings, with some half dozen odd stories of windows in their roofs, afford a marked contrast to the elegant new stone structures the German Government has built for university and hospital purposes. In this old Spital, (or hospital) which belongs to the city, and the use of which for a clinic or general diseases under Kussmaul, and an eye and ear under Laqueur, is simply accorded to the University, was given the first instruction wet nurses in Germany ever received, and I believe the same sort of instruction is still given. Some portions of the Spital are devoted entirely to the use of the city and are presided over by men not in any way connected with the university. On the whole the university is pretty thoroughly germanized, and has been so, ever since its reorganization in 1872, and is well fitted to assist in putting German ideas into Alsatian minds, as well as to carry on its legitimate educational work. For American medical students, I have no doubt, that v. Recklinghausen is the most attractive figure in the faculty. To begin with, his reputation as a pathologist is world wide, and then simply as a teacher, there are few men in Germany his superiors. He looks quite like a German-has reasonable abdominal proportions-wears spectacles, and has a little bald spot on the top of his head; but so far as mere looks go, might be anything else than a university professor. His powers of observation in the class room, are wonderful. I have seen him directing four simultaneous post-mortems, in none of which, the slightest mistakes of any of the students, or abnormalities in any organ of the subjects, escaped his eye, nor from which the class did not get the greatest possible benefit. In his courses in microscopical anatomy, if the student cannot at last tell liver from kidney, it is no fault of v. Recklinghausen's. I believe that he declares that there is no man in Strassburg over 32 years of age, who has not cirrhotic kidney, as a result of too much beer, but this statement does not seem to have affected the manufacture or consumption of this beverage, and there is the usual amount of kneiping going on every evening among the students and soldiers. The names of Hoppe-Seyler, Lücke, Goltz, Jolly, Freund, and others of the medical faculty, are likewise well known. I saw Prof. Lücke, whose clinical amphitheater is a model of most excellent, convenient and antiseptic construction, perform or try to perform, the radical operation for the relief of hernia, but by some anomaly no hernial sac was anywhere to be found, and after a long and fruitless search for it, the patient was finally sewn up and sent into the wards. The special interest for me, centured about the ophthalmic wards and clinic. Laqueur is the ordinary, Stilling the extraordinary professor, both very pleasant and able gentlemen, the latter known to us through "Stilling's operation." The clinic directed by Prof. Laqueur, is meanly housed, in a part of the Bürger Spital. The hospital wards are neat and clean, but the policlinic is obliged to get along with very insufficient facilities.. One of the interesting cases I saw was the rare one of congenital hypertrophy of the upper lid. The patient was a girl aged 17 years; one upper lid had always been larger than the other, but during the past four years it had very much increased in size, and now measured 35 mm. from orbital ridge to ciliary margin -was thick, soft and painless, with the globe and vision normal. At the present time the patient could see only through a very small space at the inner angle of the eye. In the ophthalmoscopic room, Prof. Laqueur showed me, what was to me at least new, a binocular microscope or telescope, as you choose to call it, designed for examining the external portions of the eye, iris, and anterior chamber. It gives very much magnified images, and affords the observer a splendid means of studying gross pathological changes, finding foreign bodies, etc. It is probably a double Gallilean telescope, with a working distance of 6-7 inches. For determining corneal astigmatism the ophthalmometer of Javal and Schiötz was in frequent use. This valuable instrument, in spite of the great aid it affords in the study of this anomaly of refraction, is very little employed, either in America or here in Germany. Its cost is rather too great, in its present form, but its inventors are at work I believe upon a simple model, to cost somewhere in the neighborhood of fifty francs. Prof. Stilling lectures upon the relation of constitutional and eye diseases; on refraction, and the use of the ophthalmoscope, and in addition to his university duties, has a daily clinic at the Israelitish Hospital. By invitation I called upon him at his home, and had the pleasure of looking over the advance sheets of his forthcoming work on Myopia, in which, upon the evidence of certain recent pathological studies of his, the present and ordinarily accepted theories as to the pathology of this trouble, are very much modified, if not done away with altogether. At his clinic, I found antisepsis to play an important part as a remedial agent; iodoform dusted into the eye-the iodoform bandage, if the case be severe-is largely relied upon in the treatment of inflammatory affections of the eyes, even taking the place of nitrate of silver in the treatment of ophthalmia neɔnatorum. As a city, Strassburg is not particularly interesting, ex cept for its history. Still it has a beautiful cathedral and wonderful clock, some fifty storks, more or less, who stand idly on their great nests, balancing themselves on one leg, when they are not flying leisurely about to or from some favorite frogging ground, and who, if German tradition is to be believed, ought to bring babies enough with them materially to enlarge Dr. Freund's obstetrical clinic. It has also world renowned patês of fat goose livers-prepared with all the skill of Alsatian cooks, and displayed in the most tempting little jars-plenty of the narrowest and most crooked streets, and soldiers without end. * From Strassburg to Heidelberg is only a step, geographically speaking, but once there one breathes a very different atmosphere. There is nothing Frenchy about this old place, and no need of government interference to loyalize its natives. There is a little too much of the English flavor to the population-too much of one's native tongue heard. in the Stadt Garten concerts, to harmonize with one's preconceived ideas of the town, that is all. One wishes it to be a trifle more thoroughly German. The University is more than five hundred years old, having celebrated its fifth centennial last year, and is widely known; perhaps more through its philosophical than through its medical faculty. Still this latter is of high rank and embraces many well known names. The hospitals are decent structures, largely built upon. the pavillion plan, and surrounded by well laid out grounds, luxuriating in roses and other attractive flowers. The Augen Klinik is a large and very handsome stone building, not owned by the University, but certain use of which is given to the students. Its director Prof. Geheimrath, Otto Becker, (Geheimrath you know, is only a title), has a scientific reputation which places him well in the front of German ophthalmologists. In his company I visited the various wards of the hospital. Everything is scrupulously neat. The patients are divided, in true German style, into three classes, on the basis of respectability and money. Those of the third class, form the material for the public clinics. They wear a sort of uniform, consisting of clean linen suits and slippers, and thereby look vastly better and more wholesome, than if they were allowed to wear their own, generally dirty clothes. The wards are fitted with hot water tubing and small coils for each bed, for the local application of heat to the eyes, by which the application may be made constant and uniform for as long a time as is desired. It certainly is the best thing I ever saw for the purpose. It would also be possible, though not so easy, by any means, to use a similar system of piping for the distribution of cold water, for cold applications. The wards are provided with large shutters to the windows, by which nearly absolute darkness can be secured. In this Egyptian darkness, cataract and similar operated cases are made to sit or lie out their times of probation. The hallways are large and light, and in them, upon a "Heidelberg chair" the cataract operations are performed. Large photographic copies of the Sommering bas reliefs to von Graefe's memory hang in the halls leading to the clinic room. This room, though small, is beautiful. A high arched ceiling-the walls hung with elegant drawings and engravings, professional, of course, the light coming in through one very large window, and the scrupulous cleanliness, contrive to make it one of the nicest clinic rooms in all Germany. There are treated here annually between five and six thousand eye patients and Prof. Becker holds public clinic five days in the week, before a class of twenty or twentyfive students. Heidelberg is quite an ophthalmological center, for every summer during the last of August, or early in September, the ophthalmologists from all over Germany and even from other countries, assemble for a brief session of society work, and to exchange views on the most recent advances in their specialty. The Ear Clinic of Prof. Moos, is not so favored in the matter of building, or rooms, and one has to mount some three flights of stairs, past the scenes of various sorts of domestic occupations before reaching it, for it is obscurely set in the top story of an ordinary apartment house. How |