The children's hospital, the medical school and the public / by L. Emmett Holt.
- Luther Emmett Holt
- Date:
- [1913]
Licence: In copyright
Credit: The children's hospital, the medical school and the public / by L. Emmett Holt. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![[90J Nearly the whole fabric of infantile therapeutics must be constructed anew from the standpoint of recent advances in medical science. I do not mean that patients in the hospital are to be used as subjects for experiment ; that phrase is likely to be misunder- stood. But what is new and promising must be thoroughly tested under conditions in which the most careful observations are possible; and these can only be obtained in a hospital. Proper clinical studies upon patients necessitate a liberal pro- vision for a resident staff and assistants. Their work, how- ever, can, as already suggested, be advantageously supple- mented by the medical student. All these three lines of work, student instruction, research, and the care of patients can be [91] carried on at the same time and each activity, instead of em- barrassing the others, can promote them and thus the best possible results in all be attained. I have already suggested that hospital work among very young children is quite a different problem from the hospital care of adults. There are some features upon which I would like to dwell for a few minutes. The first is that of hospital mortality. Nothing is more disturbing to hospital managers, nor at times more discouraging to a medical staff than the death rate, especially among infants. While, in a broad sense, it is true that the value of the work is to be measured by the number whose lives are saved or whose health is restored, this must not be too narrowly construed. To com- pare the mortality figures of such a hospital with one admit- ting only adults is most unjust. The proper comparison is between young children treated in a hospital and those of the same class treated outside of it. We have seen that children under five years furnish a third of all the deaths. In differ- ent cities the mortality during the first year of life varies from 150 to 350 per 1000 of infants born. Infants are the first to feel the effects of an unfavorable environment, they are the most susceptible to disease and have the smallest re- sistance to it. Whether they are received into hospitals or not the mortality of infants is very high, unnecessarily high. In the City of Baltimore your infant mortality in 1910 was 383 per 100,000 of population.](https://iiif.wellcomecollection.org/image/b22447957_0010.jp2/full/800%2C/0/default.jpg)
