any elevated rank, and is made up mainly of French doctrines at second hand.

The Italian school is immeasurably in advance of the Spanish, though sunk infinitely below the position it once occupied, when, in the days of Fabricius, Malpighi, Morgagni and Scarpa, it was the anatomical and surgical teacher of the world. Not that Italy is now altogether devoid of prominent medical men; I have found able surgeons in Naples, Florence and Bologna, and you are all familiar with the reputation of Pacchini, of Florence, the discoverer of those singular nervous bodies that bear his name, whom I found one of the most intelligent, warm-hearted and interesting men that I ever had the happiness to meet.

As I walked through the ancient palatial seats of learning at Bologna and Padua, I could but mourn over their decline in reputation from those bright and palmy days of grandeur, when their halls were thronged with the most aspiring students from all parts of Europe. The escutcheons belonging to the name and race of the more distinguished still hang in great numbers upon the walls, among which I observed that of the celebrated Harvey, the discoverer of the circulation. He was a student of Padua, and gleaned from the teachings of Fabricius of Aquapendente an insight into the mysteries of the vascular system, which led to his discovery of the circulation, and made his name famous for all time.

This lecture-room of old Fabricius, the authorities have had the good taste to preserve unchanged down to the present time. What appearance, think you, it presents?-a spacious theater, with cushioned seats, on which his audience could have reclined at ease? No, indeed. It is but a tall, narrow circular chamber, much smaller than the old lectureroom of the Pennsylvania Hospital; like a punch-bowl in shape, with narrow galleries running around, in which the students could merely squeeze themselves in a standing posture, in order to observe the demonstrations of the great man below.

But there is hope yet for Italy. Her skies remain as fair, and her soil as fertile as ever, and a brighter sun shines in her political horizon. There is yet hope for the Italian people, for they still honor their great names of the past. So I felt as I stood in the beautiful lecture-room of Bologna. The ceiling of this theater was frescoed in the highest style of art-Apollo in relief, suspended from the center; a Cupid placed upon one hand, a female figure, representing Fame,

on the other, with all the Muses gracefully grouped around. About the sides of the room, dressed in their flowing professorial robes, stood the statues of Malpighi, Bartolinus, Varolius, Arantius, and the learned Taliacotius, the inventor of the Italian method of rhinoplasty. This image of the great father of plastic surgery held the model of a nose in his left hand, such as he made from the skin of the arm, and which he seemed to regard with singular complacency. In the passage adjoining stood the great oculist of his day, with two eyes painted in the palms of his hands, emblematic of his art, and the manual dexterity for which he was so famous. And in a corner, quiet as the stone of which she was made, sat Laura Bassi, the once famous doctress of laws and lecturer on philosophy, a character such as Shakespeare might possibly have had in his mind when he drew his beautiful picture of Portia.

But let me take you on with me in my journey into Germany. I arrived in Vienna the evening of the day on which, by a vote of the parliament, the Roman Concordat had been broken. Rokitansky, the pathological anatomist, who had been ennobled by the Emperor, had just made a liberal speech, with which the town was ringing. The streets were blocked with an excited and huzzaing crowd, and the people were happy, as they felt that now all denominations might intermarry without the assent of the heirarchy.

We will first make a visit to the Royal Imperial General Hospital of Vienna-the Königlich, Kaiserlich Allgemeinen Krankenhause. We will leave the compact central portion of the city behind us, with its concentric streets made to suit the walls of olden time. We will pass out by the Scotch Gate, or Schotten Thor, cross the wide and windy glacis or esplanade, and enter, a mile and a half further on, one of the great enveloping suburbs of Vienna, called the Alsorforstadt. Here is the great hospital, covering a space of ground, equal to two of our city squares, surrounded on each side with hospital buildings. The interior space is intersected east and west, north and south, with rows of continuous houses, which likewise serve for hospital wards, habitations for some of the professors, baths, and lecturerooms. Two giants of porters, with cocked-hats and harlequin-like habiliments, usually stand, like Gog and Magog, guardians at the portal. This hospital is a little city of itself, with some thousands of inhabitants of both sexes, com

prised in the main of the sick, the deformed, the parturient, and the dying. Here is accumulated almost every variety of disease, even cases of such a disgusting nature that you almost shrink as you go your rounds from coming in contact with the walls or furniture.

The professors of clinical surgery are Baron Domreicher and Bilroth, both distinguished men, who hold twice a week varied and interesting clinics; but they will exhibit little that is new, or that would be particularly interesting to recapitulate here. Domreicher still uses the waxed thread in place of the wire ligature in the treatment of vesicovaginal fistula, and Bilroth has displaced the upper jawbone in order to cut the root of the third branch of the fifth pair of nerves for facial neuralgia, which is done by a much less dangerous process in this country. I heard him in a lecture encomiastic of American ingenuity as displayed in the manufacture of artificial limbs, describe an amusing race which took place some years ago in front of our exchange on Dock street, in which, he said, a man with only one artificial leg was beaten by his antagonist who had two.

We will go now with the small crowd that is hurrying to attend the world-renowned clinic of Professor Hebra, the man who justly holds the highest place in the world's estimation for his skill in the diagnosis and treatment of the complicated and multifarious diseases of the skin, who has, in his career, treated more than 10,000 cases of smallpox and other cutaneous diseases in proportion, and given to the world pictorial representations of them that have never been equaled.

Punctual to the hour affixed for his private course, in rolls a short man with a round and portly person, and features expressive of great sprightliness and intelligence. This is Prof. Hebra. He hangs up his hat on a peg-a fashion in which all follow him. His rostrum is a chair placed within on a slightly raised platform about twelve feet square. Upon this platform the patients are introduced, one by one, and passed along the inner side of the railing so as to exhibit their diseases to the students ranged round it without.

Most of the varieties of skin disease pass before him in the course of these lectures-syphilis, psoriasis, itch, lupus, prurigo, et id genus omne, are diagnosed with wonderful acumen and judiciously treated. Your trust in his accuracy can not be withheld. For in cases where the nature of the

disease is ambiguous or mixed, and they are often so, he has the manliness to tell you that he must withhold his opinion for another day, or till he sees the proper grounds for a diagnosis.

The examination of each case is, however, thoroughly made. No vestments stand in the way, whatever the sex may be, and there is at least no mock sentimentality on either side. Occasionally a man may enter six feet high, perhaps, step up upon the platform with military precision, and dropping a loose gown from about him, make a formal profound obeisance in a state as naked as was Adam before he began tailoring with fig leaves.

Prof. Hebra believes in the unity of syphilis, as does his colleague Prof. Sigmund, and uses mercury and sulphur in its treatment as we do. But the mode of using mercury, especially in the secondary and tertiary forms, at present in vogue with both these gentlemen, is to inject under the skin once daily the tenth part of a grain of corrosive sublimate for an adult, and the thirtieth for a child. Small as this amount is, it does not do to exceed it, or it will excite nausea and vomiting. It is thrown in, in solution, with the hypodermic syringe, under the skin of the buttocks, at the lower point of the scapula, or over the insertion of the deltoid muscle. They will tell you, however, that the value of this process is yet under trial.

The plan is to continue the treatment for twenty separate injections, and then observe the results; if necessary, recommencing the injections again after a few days. Small as is the amount of the sublimate thus introduced, it can after ten days be detected in the urine. And this is not strange; for the use of chemical tests is now brought to such a great degree of perfection that it is boldly asserted that the presence of .020 part of a grain of quinia can be detected in the urine by the means of the spectrum and the passing of an electric current through the fluid, catching the quinia on a piece of gold leaf.

The well-known compound sulphur bath of Fleming, the Surgeon-in-Chief to the Belgic armies, is the one commonly used, especially in tertiary syphilis and psoriasis. It is applied, according to the case, from two to six hours, and if you look around, you will see almost at any time a dozen male patients floating about like so many seals in one common bath tub. It is his treatment, too, for the itch, which he says he cures with this bath in half an hour, killing at

once the insects and addling the strings of eggs which they lay along so nicely in little galleries beneath the skin. It says little for the cleanliness of the habits of the people of Vienna that this disgusting disease should be so common there. It is so often found, even among the higher classes, that Hebra will tell you he finds it convenient to use a popular preparation, charged with aromatics, that he calls his aristocratic itch ointment. Even the cats and dogs of Vienna, he says, suffer with the same disease, produced by the same insect. In bad cases of pemphigus, when the bulle have given place to a delicate and imperfect cuticle, he lays his patients in a bath of perpetually flowing water, and when taken out they are dressed in an India-rubber vest and pantaloons, and even the face covered with pieces of India-rubber cloth. Bad cases of hopeless burns are put into this perpetual bath, where they find themselves easier than elsewhere, and, as Hebra will tell you, die very comfortably. But it would be tedious to go into a description of this bath, with its inclined bed and its windlass arrangement, or of his famous tar bath, or of his habit of scrubbing the bodies of his patients over with the strongest kind of soap when the skin is insensitive and incapable of absorption. When there is much cutaneous sensitiveness then the cocoa-nut oil soap is used. A friend in Vienna told me he was using, with excellent effect, this coconussenoilsodaseife in the case of a Constantinopolitanisherdudelsackpfeifer— that is to say, he was using the cocoa-nut oil soda soap in the case of a Constantinople bagpipe player.

Some simple rules Hebra follows closely in getting at the differential diagnosis between syphilis and common psoriasis. He tells you that syphilitic eruptions never itch like psoriasis; that they come frequently in the bend of the arm and in the ham, psoriasis never; and that syphilitic sores always produce a loss of tissue, and that others usually do not.

Professor Sigmund exonerates our country from the supposed opprobrium of having originated the syphilitic poison. He says it is described in the Bible as many had previously supposed, and showed me a pamphlet just published by a learned Jewish physician in which it is said that Luther, out of commendable modesty, has purposely mistranslated the passage.

To Prof. Sigmund we are indebted for the knowledge of the important fact that the raw ulcerations on the side of the tongue, and called syphilitic psoriasis, are very conta