Salpêtrière Hospital

“ 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. ”

“ 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. ”

“ Days after, the emergency wards reeked with the odor of burnt blood.
Selfishly, I admit, I hoped that the night would pass without a community misfortune. Enough of individual calamity had already crowded my day to capacity. My fellow internes accuse me of keener interest in the human angle of a hospital than in the medical. I accept their banter with amusement. I have never confided to any of them the problem that calls me to the laboratory every night. ”

“ 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. ”

“ It is a curious reflection that whilst in the present war the base hospital has been given, if anything, an undue importance, in the other war it has been practically neglected. Our great hospitals are almost entirely field hospitals, planted right in the middle of the battle, and there we keep our patients till such time as they are to all intents and purposes cured. A very few convalescent homes will admit cases which still require treatment, but only a very few. ”

“ Men forgot this later and the disease became a serious problem once more in all the hospitals of even a generation ago. The hospital organization worked out by these university men is the finest jewel in the crown of their accomplishment as applied scientists. Pope Innocent III, himself a University of Paris man, founded the Santo Spirito Hospital in Rome, summoning for that purpose the best authority on hospitals in Europe, Guy of Montpellier, and then required the bishops of the world to erect similar hospitals in their dioceses. ”

“ When the centenary of the Hospital was celebrated in 1879, a suggestion was made that an event so interesting in the history of the charity would be most fittingly commemorated by the establishment or a Suburban Hospital, where patients whose diseases are of a chronic character could be treated with advantage to themselves, and with relief to the parent institution, which is always so pressed for room that many patients have to be sent out earlier than the medical officers like. ”

“ 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. ”

“ On our own four we packed all our remaining patients and all the hospital equipment we could remove. One does not waste time when one packs under shell fire, and at the end of three-quarters of an hour there was not a patient and very little of value in the hospital. I took charge of the theatre as I knew where the things went, and I think the British working man would have been rather astonished to see how fast the big sterilizers fell apart and the operating-tables slid into their cases. ”

“ 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 expense, 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 regulations of the hospitals are nearly the same as they are in London and New York. In cases of severe wounds, persons are admitted into the hospitals without any order, by simply presenting themselves at the doors. Medical advice is given at some of the hospitals on certain days to poor persons. The hospitals of Paris are of three kinds; the general, open to all complaints for which a special hospital is not provided; the special hospitals, for the treatment of special diseases; and the alms-houses. ”

“ The glorious halls and corridors, the massive marble pillars, the splendid marble staircases, indicate wealth, but the perfection of the sanitary and scientific arrangements tells of long years of anxious thought and study and research. So perfectly is this marvellous hospital built that, in the event of plague or cholera breaking out to such an extent as to infect the building, the whole of the inside of the hospital can be removed and another hospital will still be left standing as complete as the other. ”

“ These principles, as civilization grew, education improved, and the tastes and requirements of the common people were developed, made men and women of many races realize that the treatment of disease in buildings set apart exclusively for the care of the sick was, in fact, a necessity in urban districts. The establishment of a hospital freed the streets of the abuses attendant upon beggars and other poor creatures, who made their ailments the chief ground of appeal for alms. ”

“ The atmosphere of a great city grows less and less suitable to the rapid and complete recovery of patients who may undergo the major operations or be suffering from the severe and acute forms of disease. Asepsis, it is true, has reduced the average residence in hospital from about 35 to less than 20 days. It has thereby added quite one million working days each year to the earning power of the artisan classes in London alone. ”

“ 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 ”

“ My Richmond friends never lost sight of me for one day during my service in that city. Nearly every day my little boy was sent for to play among happy children, far away from the impure atmosphere of the hospital, which was soon filled with patients suffering from almost every form of disease.
As the demand for more room became pressing, the three stories of the main building were successively utilized, as well as a large storage-room in the yard. The ground-floor contained the surgeons' and steward's offices, store-rooms, etc., while the second and third formed two immense sick-wards. ”

“ As matters stand, however, the special hospital has had to be accepted, and nothing which King Edward’s Hospital Fund has done in London has met with greater popularity and professional approval than the labours which its council have undertaken in promoting the amalgamation of the smaller special hospitals of certain kinds, so as to secure the provision of one really efficient special hospital for each speciality. ”

“ Of the 281 in-patients admitted last year, 205 had to undergo surgical operations of various kinds, 124 being serious cases; notwithstanding which the mortality showed a rate of only 5-6 per cent. As a rule many weeks and months of care and attention are needed to restore the general health of those who may have, while in the hospital, successfully recovered from an operation, but there has not hitherto been the needful funds or any organisation for following up such cases after they have left Sparkhill. ”

“ 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. ”

“ Always full to overcrowding, never less than 600 patients where we had only the equipment for 200, the whole hospital looked to her for the nursing that is so essential in modern medicine and surgery. For nurses are now an absolute necessity for medical and surgical work of modern times, and we could get no other sisters. The railway was broken, the bridges down, and where could we look for help or hospital comforts or medical necessities? We had pushed on faster than our supplies, and with the equipment of a Casualty Clearing Station we had to do the work of a Stationary Hospital. ”

“ One of these trips was to the Armory Hospital, the neatness, comfort, and convenience of which makes it an honor to its presiding genius, and arouses all the covetous propensities of such nurses as came from other hospitals to visit it.
The long, clean, warm, and airy wards, built barrack-fashion, with the nurse's room at the end, were fully appreciated by Nurse Periwinkle, whose ward and private bower were cold, dirty, inconvenient, up stairs and down stairs, and in every-body's chamber. ”

“ Nay, even at the least, the alleviation of suffering to those on whom death had already laid his hand has been no small thing; and when we know that of 240,000 out-patients who have received advice and medicines, and 10,400 in-patients whose cases have warranted their admission to the wards, a large number of actual cures have been effected since the establishment of this hospital, we are entitled to regard the institution as one of the most useful that we have ever visited together. ”

“ While this method of treatment is best carried out in the well-appointed hospital, there is no real reason why it cannot be fairly well carried out in a well-regulated private home, provided the necessary preparations have been made, a trained nurse is present, and provided, further, that the physician is willing to remain in the home with the patient the length of time required properly to supervise the treatment. ”

“ The company erected at a cost of more than $60,000 a thoroughly modern brick hospital of thirty-five bed capacity which furnishes absolutely free to its employees and their dependents every type of medical, surgical and obstetric 78 treatment. No charge is made for any hospital care, operating fees, or for medicines. ”

“ 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. ”

“ Hospitals and infirmaries would be alike nationalised, and, in place of the present antagonism between hospitals and the bulk of the medical profession, every doctor would be in touch with a hospital, thus having behind him a fully equipped and staffed institution for all purposes of diagnosis, consultation, treatment, and research, also serving for a centre of notification, registration, preventive and hygienic measures. ”

“ Good surgery demands good hospitals, and indeed inevitably creates them. Whenever hospitals are in a state of neglect, surgery is hopeless. We have, however, abundant evidence of the existence of fine hospitals in the Middle Ages, quite apart from this assumption of them, because of the surprising surgery of the period. Historical traditions from the earlier as well as the later medieval times demonstrate a magnificent development of hospital organization. ”

“ Before the move was made to Spearman's Farm the Hospital was enlarged, and the staff was increased by the addition of eight civil surgeons. It is sad to report that of these two died in the camp and others were invalided. No men could have worked better together than did the army surgeons and their civilian colleagues.
The greatest capacity of the Hospital was reached after the battle of Spion Kop, when we had in our tents about 800 wounded.
Some account of the nurses who accompanied the Hospital is given in a section which follows. ”