Volume 1
The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.
- Date:
- 1884
Licence: Public Domain Mark
Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![that the ward must be thoroughly disinfected before it can safely be used again. Surely it is more rational to commence the disinfection at the source of mischief—that is to say, the wound. A sufficient cubic space, free ventilation, and clean wounds, are therefore the essentials of a healthy hospital. Attention to these three conditions, especially the last, has in many Continental hospitals reduced the death-rate to less than a quarter of what it was in former times. Care must be taken in attending to ventilation, that the free current of air is maintained both by night and day. It is from want of this precaution during night especially that much mischief often results. The importance of maintaining efficient ventilation during night, and the little danger to be apprehended from the admission of cold night air, have been so forcibly pointed out by Miss Nightingale in her Notes on Nursing, and are now so universally admitted, that I need not do more than add the testimony of my experience to the truth of her observations. In cold weather, also, there is so great a disposition on the part of nurses and patients to shut up Avards and rooms, that the air becomes close, oppressive, and contaminated; and hence it is that erysipelas and similar diseases are so rife during winter and early spring. The “ East Wind ” is commonly accused of being the cause of these ; and no doubt it is so, but only indirectly, by causing Avindoivs and doors to be shut, so as to exclude the cold that usually accompanies that Avind, and thus rendering the atmosphere impure. It is impossible to over-estimate the importance of a free supply of pure air in lessening the mortality after operations, not only in hospitals, but equally in private dwellings. The fact has often been observed iu military practice, and the recent Franco-German War brought it into stiong relief that those Avounded fare best Avho are treated iu open huts or tents, whilst those who are placed in the apparently more favour- able conditions afforded by regular houses become decimated by those scourges of military surgical practice, pyaemia and hospital gangrene. ' It is the differ- ence in the hygienic arrangements in different hospitals that, more than any other condition, influences the varying rate of mortality in different institutions ; and it is obvious that, ccderis paribus, those patients Avill have the best pro- spect of recovery Avho are most scrupulously attended to in this respect; that no cases of operation should be placed in ill-ventilated Avards, or in those that contain more than a certain percentage of patients suffering from wounds or sores, the discharges from which are unavoidably foul; and that the performance of operations in close and ill-ventilated rooms, or in houses situated in over- clouded neighbourhoods, should, as flu- as possible, be avoided. The faulty amwlirinf ltl0nf-thi!fc aiiC Sfcm t0° frequent^ mcfc with in hospitals, are alike l 1° and an ,njnst,cc t0 the Surgeon. The cruelty to the patient consists not only in exposing him to an increased chance of death—or as it is commonly called, “ to a higher rate of mortality ” from septic diseases ^ bhab.axe the dircct outcome of the defective hygienic imneiSm ^ 1 ,1]fltlkltjon-but in subjecting him to a prolonged and thePmeasLe S ^ °V b°th °f which conditions may be taken as the measure of the neglect of sanitary arrangements in a hospital. tico to attentlS-t0 Sanitary h0spital arrangement is equally an injus- amono-Hf 1 • U1 con- is reputation suffers by an increased rate of mortality bcyoml thpir A Whi0h’ thou^ Preventable, are altogether and of care VtW hlSGOntrcJ.; aTJ undue burden of anxiety, responsibility. javii upon him by the necessity under which he lies of](https://iiif.wellcomecollection.org/image/b21974081_0001_0045.jp2/full/800%2C/0/default.jpg)
