PATHOLOGY. 
upon to be prefent at operations. A male and female 
intra-pratikant daily take the office of journalifts, whole 
duty it is to examine all women applying for admiffion, 
to be prefent at all deliveries which take place within 
the courfe of the twenty-four hours, and to enter into 
a book the names of the patients who are admitted into 
the clinic, and of thofe who are delivered during that 
day, but without any hidoryof the cafes. The appoint¬ 
ment of pratilcants continues for two months. 
Children’s beds are fcarcely ever employed in the cli¬ 
nic : the children are laid by their mothers’fide. Swad¬ 
dling, a barbarity almoft unknown in England, but 
which holds its ground in many parts of the continent of 
Europe, is not permitted. After a few hours the bread: 
is given, the mother continuing in the reclining pofture. 
Many of the mothers; indeed, refufe to give the bread: 
to their children, knowing that in not many hours they 
are to be fent to the foundling-houfe. Small as the rate 
of two-pence halfpenny a-day is, it is furprifing how 
early after delivery the patients leave the hofpital, in 
order to fave this expenfe. We have been allured that 
frequently on the fecond day, and fometimes even on 
the next day after delivery, they give up their child to 
the foundling-houfe, and return home.. The greater 
number leave the hofpital at the end of a week. Very 
few remain two weeks. 
For feveral years' pad:, profedbr Boer has given no 
clinical ledhires. Neither is there any regular lyftem of 
indrubtion in the practice of midwifery followed in the 
clinical fchool, nor is there any demonftration of the 
obftetrical inftruments, nor arty exercifing upon the 
phantom or machine, tinder the immediate direction of 
profed'or Boer. The principal part of the inftruclion to 
be gained at this clinic, mud: be gathered from his oc- 
cadonal remarks and converfational examinations. His 
affidant, indeed, gives privalijjima , both to male and fe¬ 
male pupils, at ten or dfteen paper-guldens. 
Profedor Boer is a pupil and a partifan of the Englidi 
fchool of midwifery. His forceps are nearly thofe of Dr. 
Hamilton; but he almoll feoffs at indruments, and, like 
Dr. William Hunter, fums up his advice for difdcult 
cafes, in the word Patience. He fays plainly, that 
midwifery is better underftood ig England than in any 
other country. Little, therefore, is to be learned in the 
clinic of profed'or Boer of the artificial part of midwifery ; 
while the bed opportunity is afforded of eftimating the 
value of the ars objietriciu per expert a tionem. To a 
treatife which profedbr Boer hasqmbliffied, he has given 
the title of “ Elementa Medicirtae Obftetriciae Naturalis.” 
This work is diftinguifhed for the claffic fade with which 
it is written. 
The medical treatment of the women who have been 
delivered in the clinic, is in general fo extremely dmple, 
that profedbr Boer is wont to fay, that they cure every 
thing there with beer-foup, and require neither great 
learning nor dear drugs. The number of puerperal dif- 
eafes which do occur is very fmall. This is probably 
owing in a confiderable meafure to a regulation, which 
is drirtly followed, that no woman diould be left twenty- 
fours after delivery, without having a clyder given her, 
if her bowels have not been opened. In puerperal fever, 
profedbr Boer is a friend neither to blood-letting nor to 
drong faline purgatives ; but truds, as in many other 
cafes, more to nature than to art, ordering little more 
than dome powders of ipecacuanha in the commence¬ 
ment, clyders, fome fpoonfuls of tindture of rhubarb, 
a little of Dover’s powder, and emollient cataplafms to 
tjie abdomen. In the pain of the inferior extremities 
atter delivery, with or without cedema, profedor Boer 
has derived great advantage from a blider applied like a 
garter under the knee. He maintains that abfeedes of 
the mamma are never to be opened with the knife, but 
are to be treated with poultices till they open of them- 
felves, after which neither lint nor ointment is to be ap¬ 
plied. The caufe of fuch abfeedes, he confiders to be 
Vol. XIX. No. 1287, * 
GO 
the want of timely putting the child to the bread, and of 
regular fucking. To fore nipples he applies cloths 
dipped in warm water, and orders the child to be con¬ 
tinued at the bread, its faliva being the bed remedy. 
As foon as profedbr Boer fees aphthae in a child, he 
concludes that it has had tea, fugar, or fyrup, or that it 
has ufed a fucking-cloth. Any fuch foreign irritation, 
adding upon the tender mouth of the child, caufes aphthae. 
In the clinic, as the children get nothing but their mo¬ 
thers’milk, aphthae are exceedingly rare, whereas that 
difeafe is extremely common in the foundling-houfe. In 
the ophthalmia of new-born children, profeffor Boer re- 
jefls all collyria, as irritating and likely to increafe the 
inflammation. He rejefts alfo the wadiing of the eyes 
with milk, as it is apt to be four. He places by the bed 
of the mother two cups of cold fpring-wafer. In the one 
fhe dips a bit of linen, and in the other waffies out the 
bit which die has removed. ’Thefe are frequently applied 
over the eye-lids. Under this treatment the indamma- 
tion diminifhes, the eye-lids are prevented from adhering 
together, and the purulent difeharge is faid to be averted. 
The Foundling-houfe is alfo under the fame diree- 
tion as the General Hofpital ; but dands on the oppofite 
fide of the dreet, and has its own phydeian, furgeon, and 
overfeer. Of late years it has been much improved by 
.the care of government, and the exertions of a fociety of 
the ladies of the Audrian nobility. This is called the 
“ Society of Noble Women for the Promotion of the. 
Good and Ufeful.” In 1814, the following were among 
the applications of their funds : 
Guldens; 
Care of Foundlings, and Premiums to Nurfes 9871 
Inditution for the Indruidion of the Der.fand Dumb 249a 
Inditution for the Indru6Iion of the Blind . . 3349 
Care of Patients with Difeafes of the Eye . . , 380S 
Support of poor Lying-in Women.1250 
All attempts to rear the children in the hofpital itfelf 
had failed. In the mod favourable years, only 30 chil¬ 
dren out of the 100 lived to the age of twelve months ; 
in common years, 20 out of the 100 reached that age; 
and in bad years not even 10. I11 1810, 2583 out of 
2789 died; in 1811, 2519 out of 2847 died. Like the 
cavern of Taygetus, this hofpital feemed to open its 
jaws for t'he dedrubtiori of the deferted and illegitimate 
progeny of Vienna. The emperor Jofeph II. frequently 
vidted this hofpital in perfon ; and upon oneoccaiion he 
ordered profedbr Boer to make a feries of experiments 
with all kinds of food, that it might be afeertained how 
far diet had its (hare in the mortality. Twenty children 
w'ere feledled, and fed with various kinds of paps and 
foups; but in a few months mod of them were dead. In 
1813, the government enabled that the foundling-houfe 
diould ferve merely as a depot for the children, till they 
could be delivered to the care of nurfes in different parts 
of the country. Already, this plan has in part anfwered 
the benevolent intentions of thofe who fupported it, and 
given credit to the opinion of the medical faculty, who, 
in their report upon this fubjeft, attributed the mortality 
in the foundling-houfe, not to the want of care, food, 
or cleanlinefs, but to the crowding together of fo many 
children, and the unavoidable deterioration of the at- 
mofphere which hence refulted ; to the noife, and to the 
contagious difeafes to which the children were expofed, 
and efpecially contagious diarrhoea. This hofpital dill 
continues to contain upwards of feventy nurfes, and 
more than twice that number of children. Every nurfe 
has her own bed, and befnle it two children’s beds. In 
general, each nurfe has her own child committed to her 
care, and another child. 
The Inditution for Sick Children.—This inftitution 
owes its origin to Dr. Madalier, a celebrated and bene¬ 
volent phydeian of Vienna. It is at prefent under the 
care of Dr. Goelis, at whofe-houfe in the Wollzeil-ftreet 
the vifit is daily held from three to five o’clock in the 
T afternoon. 
