Report on the charitable institutions of Melbourne / by Dr. Gresswell.

  • Gresswell, D. Astley (Dan Astley), 1853-1904.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Report on the charitable institutions of Melbourne / by Dr. Gresswell. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    EEPOET TO THE EOTAL CHAEITY CHARITABLE INSTITUTIOIS OF lELBOURNE, BY DR. G^RESSWELL. E-:sent'a!a o£ liospital- manasemcnt. Of the questious submitted to me relative to tlie Charitable Institutions of subject ot this metropolis—one, concerning provision for isolating infectious persons, has already been dealt with ; the other, concerning the conditions under which persons are placed in those institutions, forms tlie subject of this Report. It will be convenient to consider—first, the Hospitals; and, then, the Benevo- lent Asylums and institutions of like character. Hospitals. It has during recent years come to be recognised that charity, expended in the establishment and maintenance of institutions for supplying indoor medical relief, has in no small proportion of instances brought about results the very reverse of those which were anticipated, the treatment in such institutions of persons suffering from injury or from disease having so frequently resulted in accentuation of the mischief which those institutions were designed to alleviate, in contraction of other iljpess which the sufferer would in all probability have escaped at home, and, times out of number, in an unnecessarily fatal termination ; and it is accordingly nowadays accepted that the aggregation of persons suffering from injury or from disease—with the view to the care and treatment of them—in large institutions cannot be justified unless the sufferers be supplied with the best available services of the medical profession and with the best available conditions for rapid and sound recovery. Brief consideration may, perhaps, with advantage be given to some of the experiences upon which are based the foregoing observations as to the importance of wliolesomeness of the conditions incidental to hospital life. Of special interest in this connexion there is the reduction of fatality from cuts and rents of the body, accidentally or otherwise produced, which has followed the introduction of certain changes in the manner of treatment within recent years ; for the rationale of this reduction has a direct bearing on the value to be placed on wholesomeness of hospital conditions. The fatality from many forms of wounds, of surgical operations, and of such internal rents as those accompanying childbirth has fallen in proportion to the care with which the cut and rended surfaces have been preserved free from infecting agents—agents which, for the most part, may be regarded as synonymous with minute disease-producing organisms (pathogenic micro- organisms). Proof of this may be found in a variety of statistical data. The clinical and other records for maternity-hospitals will serve ia illustration, for puerperal illness and puerperal mortality have declined in those hospitals in proportion as the later methods of treatment—the sterilization-methods of asepsis and of antisepsis— have been adopted. M. le Fort has shown that the deaths among 800,000 women, delivered in European maternities before sterilization-methods were regarded of so much importance, were at the rate of 3'4 per cent.; whereas under sterilization- EviJcace ot iicci for wliolesome- ness of liosp'tal coii(Utioi:s. (Puerperal disease I)efore and aftm- iiitroduction of sterilizition- treatment.