state of medicine in spain

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that time the wound would probably befound to have been enlarged, by having been interfered with, and would become Ilarger and larger every time the attempt atcure was made. If the communication wasvery small, so as to admit, perhaps, thepoint of a sound, the application of the ac-tual cautery to the part might, most likely,be successful. The situation of the open-ing was to be ascertained by means of thespeculum, and the end of a sound, red hot,was to be applied to the part; a granulat-ing process was thus set up, and contractionwas likely to follow during the cicatrisa-tion. This operation, performed at inter-vals of a month or two, he had found effecta cure. It was advisable to keep the pa-tient prone, divide a portion of the sphinc-ter muscle, and keep a large tube in theurethra, in order that the urine might flowwithout any effort on the part of the patient.

STATE OF MEDICINE IN SPAIN.

WE have recently published several let-ters on the state of medicine in Spain, ftomwhich it would appear that the art of heal-

ing has not made the same progress in that

country which it has in several other of theEuropean states. The strictures of some ofour correspondents have been, we are in-

clined to think, more severe than just; for,if the following account of the mode ofclinical instruction pursued at the RoyalCollege of Barcelona be correct, the princi-ples upon which the medical teachers of theSpanish schools act are much more soundand comprehensive than those which we

have so frequently been compelled to con-demn in our own country.

Dr. Felix Janer, Professor of ClinicalSurgery at the Hospital of Barcelona, hasfor the last ten years adopted a method ofinstruction than which none other presentsthe same advantages. M. Janer has beenlong convinced of the necessity of compel-ling the students to study and meditate onthe cases which they observe in hospital,and for this purpose he has arranged hiswards in such a manner that each studenthas the charge and treatment of a certainnumber of patients.The students, on whom this favonr is

conferred are students of the sixth andseventh years; the rest not having as yetattained sufficient knowledge, are specta-tors, until such time as the Professor maythink them capable of directing the treat-ment of some ordinary disease.

In order to avoid all appearance of par-tiality the patients are divided into classes,according to the number of pupils? and at

the end of each list is appended the name ofthe student appointed to take charge of them,When a new patient is admitted the studenton duty is immediately informed of it, andexpected to examine the patient minutelybefore the arrival of the Professor, who, inturn, questions him before all the pupils,touching the nature of the disease, the

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symptoms present, the treatment which he proposes to adopt, &c., and corrects anyerrors into which he may have fallen. Whenthe visit is over the different clinical sta.dents, the pupils, and the Professor of Sar.gery assemble in the amphitheatre, and eachstudent, in his turn, gives a short history ofthe case or cases confided to his care, esta.blishes his diagnosis, and explains the treat.ment. The Professor then delivers a lec.ture in which he comments upon what hasbeen said, points out the omissions or errorsof the student, and makes some general cli.nical observations on the cases contained inthe hospital.

In addition to this clinical exercise, whichis repeated every day, the student is obligedto keep an exact account of the cases placedunder his care, which the Professor exam.ines every alternate day, correcting theerrors, and adding such remarks of a prac’tical nature as are suggested by the natureperiod, or peculiarities of the disease.

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During the last two or three months of theseason the pupils of the sixth year becomestrictly observers, while those of the seventhyear act as consulting physicians; the mostinteresting or difficult cases are selected,and a discussion is held before the assem.

bled pupils, and under the superintendanceof the Professor and Assistant-Surgeons.The bodies of all patients dying in the

hospital are examined with great care in

presence of all the pupils, and, in a bookkept for the purpose, an exact account of thepost-mortem appearance is registered.: The Assistant-Surgeon, in addition to hisother duties, has to draw up a compte renduevery three months of the hospital, inter-spersed with remarks on the most interest.ing cases.—Journ. des Con. Med. Chir., June,1838.

TREATMENT OF ANTHRAX WITH.OUT INCISION.

M. DUPUYTREN, amongst many other im-provements of the art of surgery, introducedthe practice of dividing anthrax by a crucialincision, from the apex to the base, and thuspreventing the strangulation which termi-nates in gangrene, and constitutes the mostdangerous point of the malady. This prac-tice is very generally adopted by surgeons ofthe present day; but M. Marini has con-

ceived, and proved by experiment, thatcases of anthrax may also be cured by ac,ting powerfully on the constitution of the