460 VIENNA.

Instruction, whereby it was decided that in futureJewish students might carry out dissecting work onlyif Jewish cadavera were available. When none wereavailable the Jewish students must not themselvesdissect, but they might watch the procedure. This regu-lation brought about a truce, but it did not put a stopto anti-Semitic demonstrations, which, indeed, havebeen so frequent that military pa,trols were stationedoutside lecture-rooms to ensure a measure of peaceamong the students. The Minister of Public Instruc-tion, Mr. Anghelescu, who considers the exclusion ofJewish students from the practical anatomy rooms tobe unfair, recently held a conference to discuss thewhole question of Jewish cadavera. As a result ofthe conference, the Minister of Public Sanitation hasissued an order to all hospitals demanding that thebodies of all patients who die in hospital, unless theyare claimed by relatives of a definite degree of con-sangninity, must be placed at the disposal of theanatomical institutes without regard as to the nation-ality or creed of the deceased. This order also appliesto provincial hospitals, and includes the conveyanceof cadavera from such hospitals to university centres.

Epidemic of Hiccough in Transylvania.For the past few weeks an epidemic of hiccough ha-

been prevalent in Transylvania, and cases are reportedfrom all the towns of the country. The cases are mildfor the most part, and the onset is marked by slightfever. The symptom of hiccough shows itself on thethird or fourth day, and lasts generally two or threedays. In treatment, aspirin in fairly large doses hasbeen the main stand-by, specific therapeutic measureshaving proved inefficacious. In some old subjectsthe fits of hiccough are very difficult to stop, but aspirinusually brings relief. No fatal case has as yet beenrecorded.

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Hardships in the Medical Profession.THE economic conditions prevailing in our country

are weighing heavily on the medical profession.Not only is the standard of living quite different fromthat to which we were accustomed a dozen yearsago (it is at least 50 per cent. lower as regardsculture and outward appearances), but also the levelof fees has dropped alarmingly. Eighty per cent. ofthe population belong to one or other of the differentsickness insurance clubs, which cuts out manyopportunities of private practice. The averageincome of a busy general practitioner in our city isabout £25 a month-and that is a bare living wage.Only about 12 per cent. obtain £30-£40 a month,and not more than 2 per cent. have more than £80.Specialists as a rule have slightly higher incomes,but few earn more than £50, whilst £100 representsa flourishing practice. Under such circumstances-the cost of living here being about the same as inEngland-a large number of doctors have given uptheir profession and have become agents for surgicalinstrument factories, or for chemists or pharmaceuticconcerns ; many have taken up a purely commercialcareer.

’

Atypical Measles.In a memorandum addressed to the practitioners

in Vienna Dr. Friedjung draws attention to the factthat the type of measles occurring in the outbreakwhich has been present in our city for the past monthis quite different from the disease described in text-books. On the whole, the decursus has been very mild,with few complications from the ears or the lungs.The prodromal symptoms are insignificant; now andthen one notices a little redness or soreness of thethroat, some cough, but no Koplik’s spots. Then aviolent and intractable cough develops, and the rashappears suddenly with high fever. At this stage,

and not before, Koplik’s spots appear. The diseasethen runs its regular rapid course, and the patientsare soon well again. As there is concurrently in thecity a fairly extensive epidemic of mild influenza,with similar bronchitic manifestations, one must beon the look-out. Many schools had to be closedtemporarily on account of these conditions amongstthe children.

The Water-Supply of Vienna.The present unparalleled scarcity of snow and

rain in the Austrian Alpine regions has caused arapid diminution of the water-supply of the capital,which derives its water from two different districtsof the Alps. The old waterworks, opened in 1885-87,comprise seven " eternal " springs at the foot ofthe Rax-Alp and the Schneeberg, two mountainsabout 60 miles to the south of Vienna. From thissource Vienna used to obtain excellent water forabout 1 millions of people. The increase of thepopulation necessitated the acquisition of new watersources. In 1910 the second waterworks were com-pleted, embracing 22 springs, which derive their waterfrom a distance of 120 miles to the south-west, andthe combined supply was sufficient for about 2,000,000inhabitants, giving each about 135 litres (280 pints)daily of pure water of medium hardness. But oflate the average yield of the wells and springs hasdiminished, and the amount of water required daily perinhabitant has gone up. Plans are now being madeto get a water-supply by means of artesian or otherwells in the vicinity of the capital. Naturally specialcare will be paid to the quality of water to be addedto the present supply. Already many physicianshave noted an increase of goitre amongst the popu-lation. The general public believes that this isdue to the Alpine water, as it comes from districts

I where goitre is endemic. And the coincidence of theuse of the second waterworks and the increase in theincidence of goitre, especially amongst the females,is striking. When the present dry winter cut downthe available daily quantity of water to about 110litres and less per head, it served as a warning that thecity could not rely on the Alpine springs alone. Inkeeping with modern ideas of hygiene and cleariliness,a daily average supply of 200 litres per head will beaimed at.

Final Settlement of the Corzflici between Prof. Mellerand the Hospital Board.

As I mentioned some time ago in a letter, a conflicthad arisen between Prof. Meller, the chief of theophthalmologic clinic and the board of the hospitaland the Ministry of Health, owing to certain allegedgrave obstacles placed in the way of scientific work.Public sentiment was definitely on the side of theprofessor, and he threatened to resign his chair anddiscontinue his lectures in the University. Aftersome heated controversy an understanding was

arrived at whereby the professor agreed to continuehis teaching. The hospital board will no longerinterfere with the administrative work of the clinic, andwill not let monetary views interfere with the receivingof patients wanted for instruction or for other reasonsby the teaching staff of the clinics.

BERLIN : INTERNATIONAL POST-GRADUATE COURSESIN MEDICINE.—A series of post-graduate courses at varioushospitals will be held ir Berlin in the spring, in conjunctionwith the Berlin Medical Faculty. The series will include thefollowing: (1) Practical Course on the Diagnosis andTreatment of Syphilis. from March 2nd to 7th ; (2) PracticalCourse in Diseases of the Digestive System ard of Meta-bolism, from March 9th to 14th ; (3) eight evening lectures onImportant Points in General Medicine, during March;(4) Supplementary Course on Special Subjectsin all Branchesof Medicine, two sections (a) from March 2nd to 28th, and(b) March 16th to 28th ; (5) Important Chapters in SocialMedicine, from March 30th to April 5th ; and (6) SpecialCourse ip Ear, Nose, and Throat, from April 20th to May 9th.Information as to lodgings, &c., and the full syllabus may beobtained on application to the offices ot the InternationalPost-Graduate Course, Luisenplatz 2-1, Berlin, N’.W. 6.

461OBITUARY.

Obituary.THE RT. Ilorr. SIR CLIFFORD ALLBUTT,

’

P.C., K.C.B., F.R,.S.,REGIUS PROFESSOR OF PHYSIC. UNIVERSITY OF CAMBRIDGE.

THE whole of the medical profession will unitewith us in regretting the death at the advanced ageof 88 of Prof. Clifford Allbutt. He was the acknow-ledged leader of the profession in this country andhad attained to this position by outstanding clinicalexperience, by an unrivalled knowledge of the literaryside of our science, and by a wonderful ability to dealwith men and things, as shown by his success in thetenure of high office, in academic teaching, and inpractical politics. He died suddenly at 1 A.M., after 10minutes’acute dyspno3a,on Sunday last in full possessionof all his faculties and discharging with promptitudeuntil the end his official duties at the University.Only three days before his death we received from hima communication, which will be found in our corre-pondence columns, showing how keenly alert he wasto the salient points in any discussion in contemporarymedical journals, and also displaying in its phraseologyhis unvarying intention not to overstate a case.

He offers no explanation of the phenomena, but reports an empirical result, knowing that on the sumof such results explanation may follow. Through-out 65 years of professional work he always main-tained a similar logical outlook.Thomas Clifford Allbutt was the son of a Suffolk

clergyman and was born at Dewsbury in Yorkshireand educated at St. Peter’s School, York. Fromschool he entered Gonville and Caius College in theyear 1857 as a scholar and graduated in the firstclass of the Natural Science Tripos. From Cambridgehe went to St. George’s Hospital and while theregraduated in medicine at Cambridge and heldthe usual resident hospital appointments. Shortly Iafterwards he took up his residence at Leeds, ’,where his professional career was from the firstan unqualified success. For while he rapidlymade a name for himself in scientific circles,he also obtained a huge consulting practice,but managed to discharge at the same time, and ’’

zealously, his duties as physician to the Leeds GeneralInfirmary, the Leeds Hospital for Women and Children, and the Leeds Fever Hospital. His reputa- tion and his influence alike spread far into the north of England, and the seniors among us can stillremember when his opinion was constantly quotedover a wide range of work as coming from " Allbuttof Leeds." As early as 18G8 his share in the improve-ment of clinical thermometry was recognised as

fundamental. and he has himself recorded what thatshare was. The first clinical thermometers were those ’’

of Casella, constructed for the well-known Prof. Aitken ’,of Netley. But these were too cumbrous for generalpractice, and for this reason the thermometer longremained a stranger to the busy practitioner. Allbuttset to work with Messrs. Harvey and Reynolds tomanufacture an accurate thermometer of a new formto be carried in a portable case, and in a paper by thelate Prof. Sims Woodhead and Mr. Varrier-Jones,published in our columns about eight years ago,Allbutt’s own account of his share in perfecting thedevice is given. The value of the new instrumentin medical investigations was not recognised quickly,despite the advocacy of Aitken and Pridgin Teale,Allbutt’s colleague at Leeds, but when the enormousaid to diagnosis furnished by the self-registeringinstrument was once perceived there was hardly apractitioner in the country who did not wonder howhe had been able to dispense with it.A second prime contribution to the technical side

of scientific medicine was also made by Allbutt atan early stage of his career, for although no particularophthalmoscope bears his name, no one man contri-buted so largely to the recognition of the value ofthe ophthalmoscope in the earliest days of its inven-

tion by Helmholtz. Fifty years ago, when the ophthal-moscope was a comparatively new instrument.many who employed it were too sanguine of the gainsto accrue from the recently acquired power to seenerves and blood-vessels in such immediate relationwith the bra,in. They saw that the instrumentshould pave the way to an improved diagnosis ofcerebral affections, and the discovery of the formsof retinitis that depend upon renal or other remotedisorder was hailed as sure to lead to advances notonly in diagnosis, but also in pathology and thera-peutics. But as time went on, these expectationsbecame less confidently expressed, for it was apparentthat the new page opened to clinical observation wasnot of the kind which he who runs may read.Persons unskilled in the use of the instrument, andunable to interpret the appearances that it revealed,not infrequently made and published serious blunders ;they afterwards neglected the help they had misused.In the meantime a few patient workers toiled steadilyon, collecting data, comparing evidence, and eliminat-ing sources of error. Among these workers CliffordAllbutt was one of the most prominent, and at theproceedings of various medical societies and in ourcolumns and in those of other professional journalshe explained methodically the use of the ophthalmo-scope, defining its range and annotating the phenomenamade apparent by its use. In 1871 he brought allthis work together into a connected volume which wasthe only existing general treatise upon its subjectat the time. The book, which dealt with the use

of the ophthalmoscope in diseases of the nervoussystem and of the kidneys in particular, but whichtook note of the employment of the new system inmany general disorders, began with an emphaticand personal testimony to the value of the directimage in the recognition of early and slight changes,explaining the common sources of error in interpreta-tion. An orderly account was then given of the varia-tions from health of the optic nerve and the retina,while the relations between these variations andintracranial and other general disorders was closelydiscussed. The work was recognised from the firstas full of sound reasoning founded upon carefulobservation, never carrying conclusions further thanthe facts would warrant, but bringing together allthe facts as far as they could be ascertained to bearupon the questions at issue. The book was reviewedin THE LANCET just 53 years ago, and how much itwas needed is indicated by the last words writtenabout it, which were : " It will convince the mostsceptical that the ophthalmoscope is an instrumentno longer to be neglected as a means of diagnosisin general medicine." In the same year he read beforethe Royal Society a paper entitled the Effect ofExercise upon the Bodily Temperature, to which Societyhe was elected in 1880 in recognition of his original andscientific services to clinical medicine. In 1883 hewas elected F.R.C.P., having in the meantime takenhis M.D. at Cambridge, and in the following year hedelivered the Goulstonian Lectures of the College,taking as his subject, Neuroses of the Viscera.

Allbutt remained at Leeds, working at the highestpossible pressure until 1889, discharging his officialduties, enlarging his private responsibilities, andresolutely informing his colleagues by papers, lectures,and addresses, dealing with an ever-expanding rangeof clinical subjects. It must be remembered here thatconsulting practice in Yorkshire 35 years ago wasphysically a strenuous affair if calls abroad werefrequent from the outlying districts, and at lengthAllbutt had to confess to himself that he was over-taxing his strength. Many offers are known to have ebeen made to him to return to London in variousdignified capacities, but these he had so promptlyrefused that some surprise was manifested when atthis time he accepted the post of Commissioner inLunacy. This he held for three years, and his know-ledge of affairs as much as his experience of the sickmade of a wise and kind man a satisfactory official,but those who knew what were his aspirations fullyendorsed the action of the authorities in choosing him