Austria was first visited in 1929, Vienna being something of a surgical Mecca for aspiring surgeons (akin to “Been to America” in the middle of the 20th century). Particularly famous was the Allgemeines Krankenhaus which was built in 1880 at the height of Billroth’s acclaim. It was here that the Hungarian Ignaz Semmelweiss made his seminal observations on the benefits of hand-washing in minimising puerperal sepsis. Operations and demonstrations were seen by the travelling group, with work of a high order observed from Professor von Eiselsberg and Professor Finsterer although there was a general air of depression and the wards were seen to be “cheerful and disorderly, with little attempt at privacy for the patients.”

The next visit to Vienna, in 1960, was something of a disaster. Most of the group stayed next to St Stephen’s Cathedral in the Royal Hotel which was being rebuilt and lacked a restaurant. The visit was arranged under the auspices of the elderly Professor Schonbauer, who occupied one of the two University Chairs of Surgery and was little in evidence, and the surgical programme was equally sketchy though operations were again seen at the Allgemeines Krankenhaus, by now very decrepit. Impoverished by the war and Russian occupation, the country had not rebuilt the hospital nor was there adequate social provision for the elderly, many of whom remained in hospital beds with nets to stop them falling out. The large Krankenhaus Lainz was also visited, built on the pavilion system popularised by Florence Nightingale, and here Professor Salzer performed a partial mastectomy on a 46 year-old lady with breast cancer who would later be treated with Iskador, prepared from mistletoe grown on pine. When used for stomach cancer the Iskador was grown on oak trees. No radiotherapy was offered. The group attended the opera (Tristan and Isolde) and also visited the Vienna Woods and Schonbrunn. At dinner they met 79-year-old Dr Lorenz Bohler, famous for his management of fractures.

In 1984 the visit proved the happiest and most instructive, again centring on the original Allgemeine Krankenhaus, with Billroth’s statue dominating the courtyard and the interior extensively refurbished. Here the programme was arranged by Max Wunderlich who had trained at St Mark’s Hospital and knew James Thomson. A special operating list had been arranged for the Bank Holiday Monday and included a skilful left hepatectomy by Professor Funovics for a tumour in a young man, and the precise radiological localisation of rectal tumours by Dr Waneck. The group saw the transplant unit, which had done 22 liver transplants. The afternoon presentations included a paper by James Robinson on the influence of Vienna on world surgery. The group also visited a new 900-bed municipal hospital (Krankenhaus Rudolf Stiftung) where they saw advanced surgical techniques and facilities, including endoscopy and interventional radiology. An extensive and interesting ward round was undertaken, but the group were surprised to learn there was little contact with academic colleagues at the Allgemeines Krankenhaus. Social excursions included the Spanish Riding School and the Seegrotte, the largest underground lakes in Europe.