Volume 1

The science and art of surgery : being a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.

John Eric Erichsen

Date:: 1877

Credit: The science and art of surgery : being a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

981/1026 page 953

$Page 10. 4.—HOSPITAL HYGIENE. Attention to hospital hygiene is by no means of so modem a date as many miglit be led to suppose. The Surgeons of the last century paid great atten tion to it, and their suceess Avas proportionately great. Thus Alanson’s- success in amputations has never been surpassed, and rarely, if ever, equalled eA’en by the aid of antiseptics and of every modern chemical and mechanical appliance. Writing in 1782 (“ Alanson on ximj)utation and the After-treat- ment,” London, 1782), ho says (Preface, p. 15), that he amputated in thirty- Ha'c cases, such as promiscuously occurred in the LiA'erpool Infirmary, iviihonl the loss of a sinijk])atient. The symptomatic fever Avas slight, and there Avas- not an instance of secondary haemorrhage in the Avhole series. Can these results be equalled iioaa' ? I doubt it much. But Alanson Avas a sanitary reformer in his day; and had his instructions been folloAA^ed, thousands of lives. Avould have been saved Avhich have since his time been Avantonly sacrificed by the neglect of hygienic measm-es. His advice is so practical that it desen'es the attentive study of the modern Siu’geon. He says: “ The air in AA'hich the case is to be conducted is a point Avorthy of your greatest attention : if possible, the room should be spacious, and in an open vrholesome situation. It is AA^ell knoAvn that in hospitals Avhich are situated iu populous toAATis and are much croAvded, the salutary influence of the air is so altered, that compound fractm-es and other important surgical cases prove peculiarly fatal, and that such fractures may alrnost certainly be cured in the country.” . . . “ The operation of amputation done in the country, as aboA’e described, AA'ill be foUoAved almost certainly Avith a speedy cure ; there the consequent symptoms are trifling, nearly the AAhole internal surface of the Avound unites by the first intention, the suppuration consequently is small.” , . . “ Jlany hospitals are so tainted by uiiAA'holesome efflima that they arc rather a pest than a rehef to the objects they contain.” (Op. cit., p. 89—92). Then foUoAV sixteen distinct paragraphs or heads of the most useful sanitary advice, Avhich “ are humbly recommended to those Avho haA’e the care of hospitals in Avant of such attention.” This code of regulations deserves careful study. In it Alanson adA'ises : That no Avard should be inhabited for more than four months at a time ; that it bo cleansed, AvhiteAvashed, and purified. That the “ bed-stocks ” be of iron ; the bedding frequently changed, and made of inexpensiA'e materials so that it may easily be reneAA^ed ; and that Avhen the AA'eather admits, it be ex-posed to the open air for several hours a day. That dirty patients bo stripped of their clothing before admission ; that they have a Avarm bath and then be clothed in dresses provided by the hospital. That the infected clothes be baked in a properly constructed oven. That iieAAdy admitted patients be put into clean, Avell-ventilated Avards. That all incurable and infectious cases, and especially chronically ulcerated logs, be refused admission. That offensive pngrenous and putrid sores be placed iu distinct rooms, and not suffered to infect a Avhole Avard. That thcro should be particular rooms proA ided for$