PATHOLOGY. 
66 
are ufually chofen from among the patients of the hof- 
pital who are admitted gratuitoufly; but, when impor¬ 
tant operations are about to be undergone, it frequently 
happens that patients who pay prefer paifing into this 
clinic. This clinic is public to everyone who leaves his 
name with the profefl'or. The lludents of furgery of the 
fecond year are obliged to attend, and to undertake the 
care of patients, as the Undents of medicine do in the 
clinic for internal difeafes. From fixty to eighty lludents 
follow the clinical vifit, but the operations are much 
more numeroufly attended. The vifit is at ten o’clock 
every morning. 
With this clinic is connedled a particular inllitution, 
or J Jlamfclwle, as it is ftyled, for the education of fur¬ 
gical operators. Profefl’or- Kern has the liberty of feledl- 
ing fix individuals from among his pupils : thefe he in- 
ftrudls privately for two years, exerciling them efpecially 
in the various operations of furgery upon the dead fub- 
jedl ; after which they are permitted publicly to operate 
upon the living. Profefl'or Kern, indeeed, leaves almoft 
all-the operations upon the clinical patients, except li¬ 
thotomy, to be performed by his pupils, while he him- 
felf takes his place as their afliftant. The pupils who are 
feledred for this purpof'e are notin every cafe lludents of 
furgery, but are fometimes graduates in medicine, whofe 
peculiar talents and inclination lead them to the practice 
of furgery. They live in the hofpital, and receive from 
the emperor a yearly ftipend, in consideration of which 
they are afterwards obliged to ferve the Hate for a certain 
period. In general they are fpeedily promoted to be 
furgeons of hofpitals, regimental lurgeons, or profefiors 
of furgery in fome of the lyceums. 
Profefl'or Kern is diftinguiflied by his extreme attach¬ 
ment to flmplicity in his furgical inftruments, and me¬ 
thods of operating. His lithotome is a fliort and thick 
knife, of a very Ample and almofl uncouth form. The 
flmplicity of his external treatment of furgical difeafes is- 
Hill more remarkable. His fchool may well be called 
the School of Nature; for he trulls almofl as little to 
art as did Maiftre Doublet, the contemporary of Ambrofe 
Pare, of whom Brantome tells us; “Et toutes fes cures 
faifoit le dit Doublet par du Ample linge blanc, et belle 
eau Ample, venant de la fontaine ou du puits.” - Pro¬ 
fefl'or Kern has baniflied from his practice almofl all the 
common applications, fuel) as ointments, plafters, 
lotions, lint, tow, and even bandages*; and has fubfti- 
tuted in their place the application of water, and a Am¬ 
ple covering of linen. This plan of treatment he fol¬ 
lows even with his private patients; and it certainly 
fliows no fmall firmnefs, to humour the prejudices of the 
public fo little, as never to prel'cribe a plafter or a fldve. 
In amputation, profefl'or Kern makes ufe of iced 
water, which hfe applies by means of a fponge to the 
l'urface of the flump, as foon as the large vefi'els are tied. 
This application, fo far from being painful, appears to 
give eai'e. The edges are then brought together by ad- 
liefive ftraps. The flump is covered with a large flat 
fponge, dipped in cold water, and wrung between the 
fingers; and this is continued for forty-eight hours. In 
fome cafes, this application is changed for a folded piece 
of linen moiftened with warm water, and applied over 
the adhefive ftraps. The fame mode of treatment is fol¬ 
lowed with all wounds after operation. The edges are 
brought together by adhefive ftraps, and then water is 
applied. No ointment, no charpie, no bandage is em¬ 
ployed. The fuccel's of profefl'or Kern in his operations 
is very great. 
The extreme flmplicity of profefl'or Kern’s practice is 
a fubjedt which never fails to excite the attention of thofe 
flrangers who vifit his clinic. The cafes under treat¬ 
ment are feen to be going on well; and the l'uccefs is ac¬ 
knowledged by all to be extraordinary. Yet the ufe of 
water,as almofl the only external remedy, is a pradlice which 
by no means meets with a favourable reception. There 
are few, even of profefl'or Kern’s pupils, who advocate 
this practice'; many feem to think it unworthy of fe- 
rious examination, and to feel as if fuch a Amplification 
of furgery were a degradation of the art; others blame 
the pradlice with much afperity, yet without^daring to 
deny the fuccefs with which they fee it attended. Thofe 
who addrefs the profefl'or upon the fubjedl, he refers to 
the patients before them ; or, if he enter into any de¬ 
fence of his opinions and practice, it is nearly in the fol¬ 
lowing manner: “ At the commencement of my furgical 
practice, I had a patient brought to me with a large 
ulcer on the leg, which had refilled all kinds of oint¬ 
ments and plafters. . I told the man to lie in bed, to re¬ 
main at reft, and to give up all applications except a 
poultice, fn three weeks the ulcer was ciofed. This, 
and many fimilar fadts, have convinced me of the bad 
effedts of the ufual treatment, and led me to the ufe of 
a more fimple plan of cure. I employ water as an indif¬ 
ferent matter, to cover a furface which is deprived of its 
natural infulator, the external Ik in, and to protect that 
furface from injurious influences. It adls favourably 
upon the circumference of the lore, as well as upon the 
lore itfelf. Ointments and plafters, on the other hand, 
are irritating and prejudicial fubftances, when brought 
into contadl with an uncovered furface, naturally unac- 
cultomed to any fuch foreign imprelflons. As wounds 
of bones, for inltance fradtures, are healed wfithout any 
external application, fo may all wounds of the foft parts 
be cured. The cure of wounds is the work of nature. 
Even gangrenous, venereal, and fcrofulous, ulcers, re¬ 
quire only a proper, internal treatment, and the ufe of 
external warmth applied by means of water. Cold, again, 
applied by means of a fponge to recent wounds, leflens 
in the moll effedlual manner the organic readtion, dimi- 
niflies pain, moderates luppuration, and prevents ner¬ 
vous affedlions. Bandages may be difpenfed with, except 
in a very few inftances. The journals of this clinic are 
open to your infpedtion.” A farther account of profef- 
for Kern’s opinions may be found in his “ Annalen der 
chirurgifchen Klinik,” 2 vols. 1809 ; and in his treatife 
“ Ueber die Abfetzung der Glieder. Wien, 1814. 
The Opthalmological Clinic.—It is neceflary accurately 
to diftinguilh thofe practitioners w>ho have of late years 
applied themfelves in Germany to the difeafes of the eye, 
from the clafs who are termed oculijis, whether of that or 
of any other country. The latter would wilh to divide 
furgery into a number of trades, of which they would 
monopolize one. The former have not confined them¬ 
felves to the eye, but all of them have come prepared to 
the ftudy of that organ by an intimate acquaintance with 
medical fcience in general, and many of them have dif- 
tinguilhed themfelves by their labours in anatomy, and 
their improvements in the pradtice of furgery; as for 
inftance, Richter, Schmidt, Barth, and Prochalka. Thefe 
men have not regarded eye-difeafes as local merely. 
They have rendered eye-operations lei’s frequent, by their 
rational and conllitutional treatment of thofe affedlions 
which give rife, under mere local and empirical manage¬ 
ment, to the morbid changes of the eye which afterwards 
call for the interference of the operator. 
Vienna is at prefent the moll celebrated fchool for the 
furgery of the eye in Germany. Profefl'or Barth, who is 
by birth a Maltefe, and (till lives in Vienna, as emeritus- 
profeil'or of anatomy, was the firft public teacher in this 
branch of furgery in Aullria. He is but little known by 
his writings on this fubjedl, not having publilhed any 
thing upon the difeafes of the eye, with which we are 
acquainted, excepting a fmall tract, in which he deferibes 
a manner of performing extradlion of the cataradl without 
an afliftant. He has many pupils, however, who Hill 
fpeak of his left’ons with refpecl; and the prefent pro¬ 
fefl'or of pradlical opthalmology was, for a coniiderable 
number of years, his afliftant. By the late John Adam 
Schmidt, the fame of Vienna as a fchool for the difeafes 
of the eye, was much dnereafed. He did not belong to 
the general hofpital, nor to the univerllty, but to tire 
jofephine 
