Reports of the practice in the clinical wards of the Royal Infirmary of Edinburgh, during the months of November and December 1817, and January 1818, and May, June, and July 1818 / by Andrew Duncan.

Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: Reports of the practice in the clinical wards of the Royal Infirmary of Edinburgh, during the months of November and December 1817, and January 1818, and May, June, and July 1818 / by Andrew Duncan. 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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    in the places where they are situated. Some of these institutions, however, it appears, publish no report, and some, it is said, even keep no re- cords. Others content themselves with publishing periodically the numbers of the patients admitted, of the deaths, cures, &c. Such a statement will furnish the means of ascertaining the rate of mortality, which may be used for instituting a comparison either with other years or periods in the same hospital, and with the rate of mortality in other hospitals. Without farther information, however, these data will be apt to lead to very er- roneous conclusions,and many circumstancesmust be taken into account before we can establish from the smaller or greater rate of mortality in hos- pitals, that they are better or worse conducted, or that their medical attendants are more or less skilful. Nay some, as Burserius and Joseph Frank, have maintained the opposite doctrine; and al- though it may at first appear paradoxical that the rate of mortality should rise with the improve- ment of management and increase of skill, yet experience in some hospitals and places warrants the conclusion in a certain respect. The morta- lity in the Hotel Dieu of Paris rose uniformly as ameliorations in its management, proceeded, after the anarchy of the revolution had ceased, and phi- lanthropic minds again attended to the miseries of the poor ; and in London, it is said, the mor- tality is highest in the best conducted hospitals. The solution of the paradox is easy. As hos- 1