Massachusetts General Hospital

“ New England Hospital students granted the privilege of visiting Massachusetts General Hospital—Letter from University of Zurich stating women are admitted on equal terms with men—Extracts from letter by Dr. Zakrzewska to Dr. Sewall on vacation in Europe—Sophia Jex-Blake collects endowment for four free beds—Dr. Samuel Cabot resumes his position of consulting surgeon—Dr. Zakrzewska resigns from service at the Dispensary, being succeeded by Dr. Helen Morton—Dr. Zakrzewska shares her service at the Hospital with Dr. ”

“ It cost the State of Massachusetts $39,312 to care for the 100 men until their death. Seventy-eight were married and left dependent wives at the time of their commission to the hospital. In addition to the 100 men who became public charges, 109 children were thrown upon society without the protection of a wage-earner. Williams estimates, on the basis of published admission figures to Massachusetts hospitals, that there are now in active life, in that state alone, 1500 persons who will, within the next five years, be taken to state hospitals with syphilitic insanity. ”

“ The Boston Free Hospital in excellence of plan and beauty of design can be excelled by none. Philadelphia boasts the two largest military hospitals in the world. Of the twenty-three in and about Washington many are worthy of all praise. The general hospital at Fort Schuyler is admirable in plan and locale, and this latter condition is found to be of vast importance. A Rebel battery, with an incurable habit of using the hospital as a target, would scarcely be so dangerous as a low, water-sogged, clayey soil, with its inevitable results of fever, rheumatism, and bowel-complaints. ”

“ No effort will be spared to render the very best service possible under the circumstances and conditions imposed.
Just what the future will hold for the Public Health Service in this work, it is now impossible to say. It appears, however, that the Public Health Service for sometime to come will be one of the designated agencies for furnishing hospital care and treatment to beneficiaries of the U. S. Veterans’ Bureau. This responsibility of supplying hospital facilities, with all that is implied, will be as adequately met as possible. ”

“ In addition, seven relief hospitals were established in Dayton View, Miami City, Edgemont, South Park, the Davis Sewing Machine Company’s plant, North Dayton, and Riverdale, with a surgeon of the medical corps of the National Guard and a corps of civilian physicians and Red Cross nurses in charge of each. These stations had maternity, general, and infectious wards. Hospital and proved infectious cases were promptly forwarded to St. Elizabeth’s or the Miami Valley Hospital. The base hospital received all cases among the companies of the National Guard on duty ”

“ I can safely say that the Hospital work, which we enlarge as fast as our means will permit, has become a power throughout the country, and the Hospital in all its appointments is more or less acknowledged as the most complete of any under the control of women physicians.
This is as good a picture of the situation here in Boston as I am able to give you. If we had gained admission into the Massachusetts Medical Society, we would stand on equal footing with the best part of the profession. ”

“ We know now that from 10 to 40 per cent of the patients of the gynecologist, the gastroenterologist, and the internist generally would be better treated if a study of the life problems were added to that of the special organs and functions. To meet this need it should be possible to have enough workers in this branch of the Hospital to take their share of the consulting and co-operation work in the wards and dispensary of the General Hospital, and perhaps even in the schools provided for the same type of people from which you draw your patients. ”

“ The chief nurses have stated that the care of the patients means only “more patients.” There is no special problem in dealing with them and under the above conditions, they accept the necessary discipline and restriction which are fundamental if hospital treatment is to succeed.
It would seem, therefore, that the problem, as has already been pointed out, exists chiefly in the U. S. Public Health Hospitals where the greater number of patients from the Veterans’ Bureau are receiving care and treatment. ”

“ The disadvantages, inseparable from general hospitals, are such as can never be counterpoised by all the regularities of medicine and regimen. Nature and kind nursing save a much greater proportion in our plain way, at a smaller expence, and with less abuse. One branch only of hospital institution is wanting with us; that is, a general establishment for those laboring under difficult cases of chirurgery. The aids of this art are not equivocal. But an able chirurgeon cannot be had in every parish. ”

“ In consequence of this, some of the most wealthy citizens have joined, and selected a healthy spot, on which they have erected a new hospital, three stories high, capable of containing seventy patients of both sexes. In this hospital, the sick, fifty in number, receive cheap and excellent accommodations. They are under the care of nurses, and are attended gratis, by the best physicians of the city. The arrangement is similar to that of the hospital at Boston, but there is less of luxury here in their management.
The public library is as yet small, though it is rapidly increasing. ”

“ Another problem is the question of creating, in connection with General hospitals, wards where patients of this sort may receive at the beginning of their treatment, their preliminary examination, where they may be evacuated home with compensation or without compensation, or evacuated to a prolonged treatment hospital for further care.
It has sometimes been difficult to get enough men, trained personnel, to man these wards. ”

“ Provided that pay wings were added to the existing voluntary and municipal hospitals, it should be found that the relatively small annual premium of £3 per annum should enable the policyholders to defray the cost of medical treatment in a pay ward or at a consultation department of a great hospital as a matter of business. In the United States of America most large towns have great hospitals, usually known as city hospitals, administered and mainly supported by the municipality. ”

“ Through the courtesy of one of the largest Boston hospitals, a clinic is held weekly in its Out-Patient Department. The hospital is in no way responsible for the clinic, simply lending the room in which the clinics are held. ”

“ The medical officers attached to the hospital in our model city are allowed to hold but one appointment at the same time, and that for a limited period. Thus every medical man in the city obtains the equal advantage of hospital practice, and the value of the best medical and surgical skill is fairly equalised through the whole community.
In addition to the hospital building is a separate block, furnished with wards, constructed in the same way as the general wards, for the reception of children suffering from any of the infectious diseases. ”

“ The closure of the Walter Reed Army Medical Center in Washington, D.C., and the resulting construction of the National Military Medical Center at the National Naval Medical Center, Bethesda, Maryland, and a new military hospital at Fort Belvoir, Virginia, offer the Department of Defense the opportunity to provide state-of-the-art and world-class medical facilities offering the highest quality of joint service care for members of the Armed Forces and their families. ”

“ No doubt this policy of amalgamation will be steadily pursued, and in the course of years every great city will gradually reorganize its hospital methods so as to secure that, whether the patients are treated in a general hospital or in a special hospital, the average efficiency in every institution shall be as high and as good as possible. ”

“ The General Hospital is understood to be at the base of operations: and this supposes, as a part of its organization, a system of transport, not only good of its kind, but adequate to any demands consequent on a great battle, or the spread of an epidemic in the camp. The nearer the hospital is to the active force, the better, of course; but there are conditions to be fulfilled first. It must be safe from the enemy. ”

“ I felt sorrier and sorrier for her, though, as she went on down Cambridge Street, past all those liquor and provision and second-hand furniture shops, with the tenements over them, and I was so thankful for her when she turned out of all this, and we crossed over and went into a quiet old street, and came out upon the pretty grounds of the Massachusetts Hospital ”

“ He stated further that he believed that the specialized patient in a general hospital is better off than if in a special hospital, but that if he had a son who had a special ailment he would much prefer him in a hospital which had upon its staff men in active practice of the kind he was going to need. ”

“ Wishing the founders long life, to witness the happiness which they have prepared, the Governor General called for and lead three cheers for the founders and three for Her Majesty.
The Hospital consists of three really separate buildings, connected together by stone bridges. Viewed from the front on Pine Avenue, the hospital appears to form three sides of a square, but it is in reality H-shaped. The central part is the administration block, while the two wings contain the wards and accessory rooms, the theatres and chemical laboratory, etc. ”

“ The current system of large hospitals is abandoned, as being equivalent to 'warehousing diseases on the largest possible scale;' while special hospitals are deemed unnecessary—'as if the different organs could walk out of the body and present themselves for separate treatment.' Each hospital has an ambulance ready to be sent out to bring any injured persons to the institution; the ambulance drives straight into the hospital, where a bed of the same height on silent wheels receives the patient, and conveys him or her to a ward. ”

“ For the great mass of the people, cases of severe illness or injury, or those requiring major surgical operations, can be treated more successfully in well-appointed hospitals than in private houses, and as this is becoming generally understood the old feeling against entering a hospital for treatment is rapidly disappearing. ”

“ Many of them may be said to be above praise; but some, it is to be feared, are almost beneath contempt. Indeed, the opinion of those in the medical profession best able to judge of the matter is, we believe, strongly opposed to the multiplication of special hospitals, except of course for those diseases which cannot be advantageously treated in the general hospitals. Enumerating now the special hospitals and dispensaries in their alphabetical order, first of all come those for the treatment of cancer, of which there are two. Then there are eight hospitals for children. ”

“ In the result, especially as such special departments as there were in connexion with general hospitals were too often starved for want of means and men for their development and improvement, the younger spirits called their friends together and began to start special hospitals. To-day every really efficient clinical general hospital has within its walls special departments of almost every description, which have been made as efficient and up-to-date as money and knowledge can make them. ”

“ A dozen doctors, with each his smattering of patients, can learn and teach but little while they work apart: whereas a regular system of inquiry and record, in action where the sick are brought in in battalions, is the best possible agency. Not only are these objects lost when surgeons are allowed to make the great hospital a mere receptacle for a cluster of small and desultory hospitals, but the advantages of a broad study of diseases and their treatment are lost. ”

“ It is easily seen from such a description of a modern operation that no case can receive due care in one of our modern homes, even the best. The facilities do not exist, and hence surgeons are more and more declining to do operations, whether for accident or disease, in private houses, except in a case of absolute necessity, and a happy custom is growing more and more in favor with the community of having all operations and all accidents cared for in a well-equipped hospital. ”

“ In such a hospital no patient can be overlooked, no wrong or imperfect diagnosis can long remain undiscovered and unrectified, and nowhere else have the patients so continuous a guarantee that the treatment they receive will be of the best, while the provision made for their comfort and welfare, owing to the unceasing and ever varying quality of the criticism to which the work of everybody, from the senior physician to the humblest official, is subjected in a clinical hospital, is unequalled anywhere else. ”

“ On March 8, 1892, the hospital was purchased by Drs. W. L. Cuddeback and H. B. Swartwout, who enlarged and remodeled it, providing additional private rooms, the use of which was extended to outside physicians. The hospital was again sold on September 1, 1895, the purchasers beings several physicians living in Port Jervis and vicinity, who formed a corporation for that purpose. The hospital, besides doing general work, has always especially provided for the care of the injured employees of the Erie Railroad Company. ”