808 



HOSPITAL HOSPITAL FEVER. 



minor operations, and tukes care of all casualties 

 und accidents in the absence of the principal sur- 

 geons. Both these parties keep a set of books, in 

 which they enter in writing all the details of their 

 respective duties. The apothecary takes care of 

 the pharmacy and prepares all the medicines pre- 

 scribed from time to time by the surgeons and 

 physicians. There is a well lighted room set 

 apart for the performance of operations, and a 

 dead room for the reception of corpses previous to 

 interment. The dressing the sores, &c., of the in- 

 firm is performed by the young hospital pupils, 

 under the directions of the surgeons. The nurses 

 relieve each other day and night in a regular man- 

 ner. Particular wards are set aside for the reception 

 of persons labouring under various and peculiar 

 denominations of disease, and their distribution is 

 regulated by the house surgeon, under the control 

 of the physicians and surgeons. The doors of the 

 hospital are guarded, and kept under lock and key, 

 and the porter receives orders not to admit wine, 

 spirits, tobacco, or any improper articles to the sick, 

 unless with the approbation first obtained horn the 

 house. The relations of the sick are only admitted 

 at certain hours on certain days, except on special 

 occasions. There is a garden or airing ground 

 attached to most hospitals, where the convalescents 

 being permitted to walk about, are further restrained 

 from quitting the house, unless by the expres^ con- 

 currence of the surgeons and physicians. The 

 greatest care and attention is paid to the cleanliness 

 and ventilation of the wards, and the windows open 

 at top and bottom. The flock beddings are frequent- 

 ly destroyed and renewed. All contagious diseases 

 are placed either in separate wards or distinct 

 buildings. The chaplain is instructed to read 

 prayers daily to the sick, and to administer the 

 sacrament and consolations of religion to those 

 whose minds are prepared to receive them. All 

 patients who are disorderly or disobedient are dis- 

 charged. The general management and control of 

 the house is vested generally in a committee of sub- 

 scribers, who meet once a week or fortnight, and 

 receive reports of vacant beds, deaths, and other 

 casualties. There are generally two days in the 

 week set apart for discharging and receiving 

 patients. But accidents are received at all times 

 and at all hours. All patients bring with them let- 

 ters of recommendation from annual subscribers or 

 governors, by the form of which the person recom- 

 mending binds himself to remove the patients, if 

 required, or should they die, to be answerable for 

 the expenses of their funerals. The matron, house 

 surgeon, secretary, and chaplain generally receive 

 an annual salary and board. The surgeons and 

 physicians are rewarded only by votes of thanks or 

 permission to receive fees from the hospital pupils. 

 In some county hospitals there are medical libraries 

 annexed to the house for the use of the medical 

 officers and pupils, who subscribe a small sum an- 

 nually to their support ; and sometimes too there is 

 a museum of specimens of morbid anatomy. Some- 

 times the surgeons and physicians read clinical lec- 

 tures on the treatment of rare and dangerous cases. 



The great advantages arising to the public from 

 well regulated hospitals can be easily understood 

 and appreciated. To the forlorn and destitute poor 

 they are a blessed retreat in the hour of calamity and 

 need ; while they afford an admirable opportunity 

 for the improvement and acquisition of surgical and 

 medical science. Almost all the greatest improve- 

 ments in the practice of medicine and surgery have 

 been imagined and carried into effect by the officers 

 >f public charities. The advantages of lunatic 

 asylums and lock hospitals have long been felt 



and confessed by all ranks of society. In a word, 

 there cannot be a more delightful reflection, than tin- 

 consciousness of being in any way instrumental in 

 clothing and feeding, and curing these poor victims 

 of disease and misery. Neither is there any other 

 method whereby so much charity can be dispensed in 

 so truly economical a manner. 



HOSPITAL FEVER is a malignant form of fever, 

 which has received this title from its being most fre- 

 quently met with in places of this sort, especially in 

 military and other large hospitals, where many men 

 are shut up in a small place and in close air. Under 

 such circumstances, almost any fever will assume a 

 more malignant character, and become more or less 

 contagious. The causes of common hospital fever 

 are to be found in the want of good and wholesome 

 provisions, fatigue, care, and anxiety, and, more 

 especially, the corruption of the air, which is always 

 produced by many men living in even a large build- 

 ing, or by fewer, if shut up in a small space ; and 

 these causes are found to produce this effect, not only 

 upon the soldier, but upon the poor, of all kinds, and 

 in all places. A similar disease is developed among 

 those confined in prisons and ships, and among the 

 inhabitants of damp, narrow huts, and is called gao', 

 ship, or typhus fever. The common fever, which 

 often prevails under the last name, has not, indeed, 

 all the characteristics of this form of fever, although 

 it easily assumes them. The hospital fever is only a 

 high degree of that form of disease which is usually 

 called a putrid, or putrid nervous fever ; that is, 

 a fever with diminished power and action of the 

 whole nervous system. The contagion produced by 

 hospital, or putrid fever, is capable of producing 

 fever in others, although the fever so produced is 

 often of a different character and appearance; 

 and it should be remarked, that it almost ceases 

 to be contagious by removal to a pure air and 

 well ventilated apartments. The form assumed by 

 the disease is much affected by the general state of 

 the weather, and by the constitution of the individual. 

 In strong, young, well fed, and rull-blooded persons 

 in whom the arterial system is full, and an inflamma- 

 tory disposition much developed by stimulating drinks, 

 or a dry, cold air, which is very favourable to inflam- 

 mation, an inflammatory excitement of the whole 

 nervous system takes place, which may even run to 

 the height of an inflammation of the brain, with 

 delirium, &c. In others, who have been much 

 reduced by bad diet, and by exposure to warm, moist 

 weather, a gastric form of fever is developed, attend- 

 ed also with violent nervous symptoms. If it happens 

 to seize persons in whom the nervous and circulatory 

 systems are much debilitated by any of the causes 

 above named, a fever more like the true hospital fever 

 is produced, which is termed a typhus, putrid, or 

 adynamic fever. In truth, we scarce ever see a form 

 of this fever which is quite unmixed, but all the forms 

 pass into each other, with innumerable shades of 

 accidental difference, arising from difference of the 

 parts most affected, &c. It will therefore be at once 

 evident, that no universal mode of treatment can be 

 laid down, but that the treatment must be varied ac- 

 cording to the causes of the disease, the state, consti- 

 tution, and previous habits of the sick, &c., and 

 according to the changes which are constantly oc- 

 curring in the course of the disease. The most 

 important modes of guarding against the hospital 

 fever, are to remove the causes of it, to purify the 

 air, to improve the nourishment, allowing a generous 

 diet, and to prevent the sick from being accumulated 

 in great numbers in one apartment. The wards or 

 rooms in which they are or have been collected, 

 should be purified by the vapours of strong mineral 

 acids, which are easily obtained by mixing common 



