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LYING-IN HOSPITALS. In Scotland, the largest hospital is in Glasgow, 600 beds; and next is the Edinburgh, 500 beds, admitting all diseases, but in five distinct buildings. The Aberdeen infirmary has 300 beds, but only half of them are usually occupied.
The Paris hospitals are remarkable for having 563 baths, which even out-patients use, so that 1,200 baths are often given at St. Louis in a day.
The county hospitals of England are faulty, from the distance which patients must travel and the difficulty of admission to many persons ill with an acute disease, the beds being filled with chronic cases which governors have forced in. The wealthy are most generous to them, and Dr. Chadwick last month bestowed £12,000 on the medical charities of his town, Bolton. In moderatesized towns there should be only one hospital, and the smaller ones, and even the dispensaries, could be readily amalgamated with it. For such reasons the establishment of small hospitals in villages has been warmly supported.
Sir J. Simpson, in his address to the Social Science Congress at Belfast, argued that mortality in lying-inhospitals was many times greater than among parturient women at their homes, in the proportion of 29 and 212. The same argument has been often quoted, but it is forgotten that much more severe cases are treated in the former situation, and that the statistics of home practice or extern maternities are very imperfect, and that we may hear of unsuccessful cases with no great certainty. Very many women's lives are saved in hospitals which, from want of attendance and nourishment, would be lost in their wretched abodes, as can be, in regard to difficult cases, amply demonstrated by statistics.
It cannot be doubted that the students of maternity charities, called during the night through the purlieus of a city to cases they do not usually revisit, afford imperfect aid to the patients, and scarcely improve themselves in the obstetric art.
Dr. E. Kennedy lately advocated the removal of the Rotundo Hospital to some thirty cottages to be built in Rutland-square. These cottages should not be made of iron, as Sir J. Simpson recommended, as such are, from the want of porosity, most unwholesome. Owing to financial reasons, the project met with little support. The master's receipts for pupils, which exceed £1,000 yearly, it was proposed to reduce. This great hospital, like those of Dr. Stevens, the Lock, and Sir Patrick Dun, was established by a medical man, and Dr. Mosse devoted the energies of his lifeor indeed life itself, for, worn out by anxiety, he sank at the age of forty
The Lying-in Hospital was located first in South George-street in 1745. It afterwards afforded the most notable instance ever adduced of the efficacy of ventilation in lowering mortality ; and by watchful efforts to ensure a free supply of air through the building, the destroyer of puerperal fever, it will continue to be esteemed as one of the noblest charitable institutions of Europe. One-seventh of the children born in Dublin are delivered in it.
But those able to pay for attendance at home should be excluded, especially if it proved that the applications are more numerous than the number which can be admitted with safety. Mr. Phelan has published a table, from which it appears that while 1 in every 6 children died during the first four masterships, on the average but 1 in 119 died during the 12th, 13th, and 14th of such periods. If poor lying-in women be received into an hospital were no surgical patients are treated, and where the women are cared in small, yet roomy and never overcrowded wards, with a nurse for only a few, they must surely be placed under circumstances more favourable to recovery than if they lay in the squalid and unwholesome rooms from which they come.
If this be so, the question of relative expense should never be considered. Smallwards are desirable, as thus, should a puer
peral fever case arise, the danger is lessened, and if operative steps are needed in one case, but a small number of women are depressed—and during the parturient period the psychical state is morbidly impressionable. The excessive mortality in the Vienna Lying-in Hospital was proved to depend on inoculation with cadaveric matter from the hands of anatomical students, and this with similar instances affords reasons why obstetric practitioners should not follow anatomical pursuits, or even undertake surgical operations.
While it is desirable that there should be separate wards for children, as at St. Vincent's, Meath, and Adelaide in this city, hospitals for children alone seem wholly unnecessary.
The practice of getting úp little special hospitals by the friends of medical men appears to be nearly two centuries, and for it is exposed in Smollett's novels; but it has now nearly come to its end in London by the determination of hospital anthorities to found special departments of their institutions. In 1687 the College of Physicians strove to suppress it by voting that everyone of its body should prescribe gratis for the poor; but so great was the difficulty of paying for the medicine, that the prescriptions were usually cast away outside the doctor's door. Special hospitals should be discouraged, as no one who limits himself to the study of one branch of pathology can have a comprehensive knowledge of other maladies incident to it, as they would deprive ordinary hospital students of opportunities of learning these diseases, and as they entail useless expense on the benevolent by multiplying buildings and officers for the charities.
The Contagious Diseases Acts (1864 and 1866) were passed for the prevention of syphilis among soldiers and sailors at a few stations-Aldershot, Plymouth, Curragh, and Queenstown, for example. If there be reason to suppose that a woman is a prostitute and is diseased,
among the "
she may be forced to submit to examination by a surgeon, and to go to hospital if she be suffering from venereal. It is reported that great diminution of these diseases has resulted-in Plymouth to one-twentieth of their former extent, and many unfortunates have been reclaimed. For these reasons a most influential association has been formed for procuring the extension of these acts to civil populations. In London, Messrs. Curgenven and Berkeley Hill, and in Dublin, Mr. Labatt, act as secretaries. The main difficulty which the project will have to encounter is the want of hospital accommodation and the expense of providing it, which have heretofore prevented the government extending the benefits of the Act to all military and naval stations. At the Curragh no hospital was available, but the authorities have procured a site, having been probably urged by the exposure of the evils of prostitution
wrens of the Curragh.” The Venereal Diseases' Commission, the International Congress at Paris, 1867, and the Harveian Society, have all advocated the expediency of these repressive measures. The latter body recommended a registration of prostitutės for the use of the authorities, but not to be in any way accessible to the public.
The evils of admitting degraded females into general hospitals and workhouses were fearfully exemplified during the partial closure of the Westmoreland Lock Hospital a few years ago.
The number of Lock Hospitals should be increased, a result which will flow from the Contagious Diseases Act. Dr. Percival eloquently described the benefits of such an institution : “ It provides relief for a painful and loathsome distemper, which contaminates in its progress the innocent as well as the guilty, and extends its baneful influence to future generations. It restores to virtue and to religion those votaries whom pleasure has seduced or villany betrayed, and who now feel by
sad experience that ruin, misery, and disgrace are the
wages of sin."
While female virtue is so general, it must be acknowledged that prostitution is marked by greater effrontery in Dublin than in most cities, and it is incumbent on the local authorities to exclude from the most public thoroughfares—at least during the day, when virtuous females are offended—women whom dress, paint, and gesture proclaim to be prostitutes. Military authorities, and those charged with the education of young men, should severely punish any of those under their care who were guilty of offensive lewdness or seduction. It may be here noted that some investigations lately made in Edinburgh completely acquitted the students of medi. cine of the detestable crime just named.
HOSPITAL AND SCHOOL ELECTIONS. The modes of election to hospitals and medical schools are almost as various as they themselves are; and, although from the pure motives of those to whom they have been entrusted, they have frequently worked well, yet much improvement is possible. The methods of election followed, for instance, in this city, are--First, by existing medical officers, as in at least three hospitals and several medical schools. This is open to the objection of excluding all but relatives of the electors or former pupils of such institutions. Second, by board of governors appointed by the Lord Lieutenant, as in one hospital until lately directly governmental, or elected from subscribers (who should have been so for some fixed period previously, as otherwise it is open to grave objections). This is followed by three hospitals and a school in this city, and it is, precautions, a safe method, and the one invariably followed in London. Third, by the governing body of licensing institutions, as is the case in one hospital and two schools of medicine. No mode could be