Middlesex Hospital

“ He was elected physician to the Middlesex Hospital on 13 July 1773, and resigned in 1777, when he was elected physician to St. Thomas's Hospital, and so continued till 1783, when his extensive private practice caused him to resign. In 1788 he was asked to attend George III, and in 1797 was appointed physician-extraordinary, and in 1806 physician-in-ordinary. ”

“ No single subject thus taught is the direct and primary object of your learning. The art of healing is so. You learn other things that you may understand this; and in hospitals at least you learn them with that view exclusively. If you wish to be a physiologist, chemist, or botanist, irrespectively of the medical application of the sciences of physiology, chemistry, and botany, there are better schools than the Middlesex Hospital, or, indeed, than any hospital whatever. ”

“ He obtained a license to practise from the Apothecaries' Company in 1848, and was admitted a member of the Royal College of Surgeons of England in 1850. He acted as resident medical officer at the Middlesex Hospital in 1848–9, and he became a resident surgeon to the Royal Free Hospital in 1850. ”

“ If the case be a common one, you get so much familiarity with a phenomenon that it will be continually presenting itself. If a rare one, you have seen what you may seldom see again. There is every reason for taking the practice of the hospital exactly as you find it. It represents the diseases of the largest class of mankind—the poor; and, although in some of the details there may be a difference, upon the whole the forms of disease that are the commonest in hospitals are the commonest in the world at large ”

“ New schools of medicine and new hospitals were rising, and the officers connected with this hospital were desirous—I am quoting their own words:—"That the liberal support which the Institution receives from a generous public should be repaid to society by a continual provision of skilful practitioners, made such by a knowledge to be acquired in the Hospital, being convinced that there is an intimate connection between the promotion of its immediate purposes and the extension of that science on which the relief and prevention of disease depend." ”

“ Bartholomew's hospital, the total in the three will be 10,617: add to these, the number cured in the hospitals at Hyde-park corner and Westminster, the London Infirmary, the Middlesex, Small-pox, Bethlehem, and other hospitals in London, and they will amount to 15,000 at least. Add to this number the patients cured in the hospitals at Winchester, Bath, Bristol, Newcastle, Shrewsbury, Northampton, Liverpool, and the two hospitals at Exeter; I think there are fourteen of them out of London in different counties ”

“ Thomas' Hospitals, now in process of construction at the Surrey Side of the Thames, in Lambeth, opposite the Houses of Parliament, will combine a number of hospitals for Special Diseases, and will accommodate about 2,000 patients, with as many beds, and will have an income of £50,000 a year, or more.
It is impossible to think of any disease, complaint, deformity, or injury to any member or organ of the body, which has not its special hospital or institution for relief or cure, in the English metropolis. ”

“ It was scarcely before the beginning of the eighteenth century that the hospitals of London began to be of any importance in the teaching of medicine. The earliest hospitals in London were leper hospitals, for at one time leprosy abounded in this city. St. James’s Palace is built on the site of a hospital for “maidens that were leprous;” the name Spitalfields reminds us that at one time there was a “spittle” here for lepers. There were other hospitals of a similar kind in Southwark and Kingsland. ”

“ Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves. The old prejudice against hospital treatment has disappeared, for the least intelligent members of the population now understand that, when a citizen is sick, there is no place so good as the wards of a well-administered hospital. ”

“ This institution at first met with great opposition; but in 1832 its value became widely recognised, owing to the fact that it alone, of all the London hospitals, received cholera patients. In 1843 the hospital was moved into Gray's Inn Road, to a site previously occupied by the light horse volunteers of the city of London, a site which was afterwards purchased by the beneficence of wealthy friends, and upon it was built the Royal Free Hospital, Dr. Marsden becoming its senior surgeon. ”

“ Mark’s Workhouse! Don’t you think the doctors content themselves with using the best of their already acquired knowledge there?” asked Mildred.
“Yet, the poor think much more highly of hospital than of infirmary treatment.”
“Naturally. It is drummed into them a hundred times a day by everybody in the place, that everything is being done 258 for their benefit. Papa told me of ‘a very pretty knee case’ which had been fourteen months in the wards, merely because it was an object of surgical interest, and was the subject of a monograph.” ”

“ Our hospitals in London are always crowded, the waiting-lists mount up till it seems hopeless to attack them, and all the time it is because we have no base hospital down in the country to which our patients might be sent to recover. I wonder how long it will be before each of the great London hospitals has its own base down in the country, with its own motor ambulances and its own ambulance coaches to carry its patients in comfort by rail to surroundings where they could recover as can never be possible in the middle of the London slums? ”

“ Often, too, these diseases rose to the height of epidemic pestilences, so that patients, however extreme their need, dreaded the very name of hospital, and the most skilful surgeons distrusted their own craft. New hospitals or new wards were built, yet after a very short time the new became as pestiferous as the old; and even scrupulous care in ventilation and housemaids’ cleanliness failed to prevent the devastation. Surgery had enlarged its freedom, but only to find the weight of its new responsibilities more than it could bear. ”

“ Of the other military hospitals, the statistics of which are given in Table IV., Devonport and Portsmouth are unsuitable adapted buildings. Aldershot Hospital consists of a number of huts joined together as a general female hospital, with accommodation for all kinds of cases, including 43lying-in cases. ”

“ During Milton’s life there stood on Bishopsgate Street the first charitable institution for the insane that was ever established. Its name, “Bethlehem Hospital,” was corrupted into Bedlam, and has become a term of general application to scenes of disorder. Just after Milton’s death, it was removed to Southwark, where the gray dome of the present structure rises conspicuous amid the London smoke. ”

“ The bedsteads are of wood; upon inquiring why they were not of iron, they replied, they were afraid to use them, on account of the heavy thunder-storms which frequently occur. Six physicians and four surgeons are attached to the hospital, and alternately attend. One physician and one surgeon live free of expense in the hospital, and one of them must always be present for extraordinary cases. The apothecary’s shop attached to the hospital is kept very neatly; however, it appeared to me to be inferior to those in the hospitals of Boston and Montreal. ”

“ It was opened in 1901 as a hospital for women, with a dispensary and out-patient department, admitting cases of accident and general illness as well as maternity patients. After nine years, it was decided to draft the general cases from the district to the Edinburgh Hospital for Women and Children, and The Hospice devoted all its beds to maternity cases. ”

“ These Hospitals were freely used by wounded men of all units from the front, and became the radiant centres of a large number of War Hospitals in the county. From the parent institutions in Leeds and Sheffield, Auxiliary Hospitals sprang up throughout the West Riding of Yorkshire, as many as 6,500 beds being affiliated to the 2nd Northern General Hospital alone. From August, 1914, till late in 1919, this splendid work, of which the foundations were laid in peace-time, was in full swing, and should form an important chapter in a complete history of the Territorial Force. ”

“ If we close the ward to visitors ... we have never in all the years the hospital has been in existence done ... that! Public confidence is our greatest asset. Has been. What shall we do? The newspapers, the police, the reputation of the hospital, d’y’see?”
“Too well, sir.”
But the tension was wearing itself out in speech and Dr. MacArthur went on:
“The hysteria among the nursing and medical staffs was bad enough, God knows, but before today is over, we must face the hysteria manifesting itself among the menial staff. How can a hospital run without orderlies, electricians, cooks? ”

“ There are about 600 beds in 187 the hospital; twenty are for midwifery, especially under Dr. Oldham’s care, providing about 1,800 cases in the year, and looked after by four young students, who are maintained by the hospital for that purpose. There was a room especially devoted to electrical treatment. The whole establishment bore the marks of wealth.
July 15.—Wished Dr. Oldham good-bye, who expressed great friendliness, wished to see my sister should she visit England, and offers to make an application for admission to Guy’s Hospital.... ”

“ During its two years of work for the sick and wounded, no military hospital has succeeded in establishing a finer record. To see it is a wonderful experience. The hospital consists of 17 wards, with 578 beds, and is entirely staffed by women—surgeons, doctors, pathologists, oculists, dental surgeons, anæsthetists, dispensers, nurses, orderlies. The only men are the patients.
Sir Alfred Keogh, the Director-General of the Army Medical Service, said, when speaking of it: “The hospital is in every respect a military hospital, differing in no way from any other military hospital in the country. ”

“ There can be no doubt that the children’s ward or wards in a big voluntary hospital is a most valuable asset to the managers, so long as the children are treated in separate wards. There is no reason of course why a hospital should confine its work to the treatment of children, exclusively. Still this special hospital is popular with the public; it has led to many discoveries and developments in the treatment of children’s diseases; on the whole the administration of these establishments has been good ”

“ Nowadays, despite, or possibly because of, the fact that operative interference is the rule rather than the exception in the treatment of hospital patients, and in consequence of the introduction of antiseptic and aseptic methods, the mortality in hospitals is, in all the circumstances, relatively less, and probably materially less, than it is even amongst patients who are attended in their own homes. ”

“ There is certainly no city better provided with hospitals than London, nor any city where more money is annually subscribed for their maintenance, nor any where the medical staff are paid so little and do so much. In East London there is the magnificent foundation of the London Hospital, which receives 11,500 in-patients every year, has an endowment of £20,000 a year, and an additional income, from voluntary subscriptions, of £40,000 a year. The story of the Children’s Hospital and its beginnings in the hamlet of Ratcliffe has been already told. ”

“ He was of opinion that in such cases a hospital should be required to terminate its own cases and not dump them off on other institutions and stated that at the Speedway Hospital there is no hesitation about reporting such cases as they are found, and if officers who transfer patients would give specific reasons as to why patients need hospital treatment, there will not be so many men coming into hospitals who do not require treatment anywhere. ”

“ The methods and procedures of the delivery-room can be just as good in the case of the very poor woman as in the case of the magnate's wife. In no way and for no reason fear the hospital. It is the cleanest, safest, and by far the cheapest way. The weekly amount paid includes the board of the patient, the routine care, and all appliances and supplies of every sort that will be used. Under no circumstances should a midwife be engaged. Any reputable physician or any intellectual minister will advise that. Let your choice be either the hospital or the home ”

“ John's House to the wards of King's College Hospital was sanctioned. Facts prove more than arguments and theories in favour of a cause, and so it has been in this case; for after years of steady and progressive work, the soundness and excellence of the principles and the practice have been established, and at the present time the services of these ladies and nurses are demanded in several other hospitals, both in London and the country. ”

“ At least two physicians should reside in the building. It is unfortunate that reception buildings as a rule are entirely too small. They should be large enough so that the acute and recoverable cases, as well as those found on observation not to require hospital treatment, can be returned to their homes without any further contact with the hospital or the necessity of a protracted residence with the chronic and purely custodial cases. ”

“ The name Bedlam is a corruption of Bethlehem, since adopted into the English language to express a place where fools do congregate. Bridewell and Christ's Hospital, which were the other two of the institutions long known as the five Royal Hospitals of London, also seem either to have been founded, or to have received a great stimulus and reorganization in the Thirteenth Century, but both ceased after some time to be places for the reception, of the ailing and became, one of them a prison and the other a school. ”