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Notes on Hospitals: Being Two Papers Read Before the National Association for the Promotion of Social Science, at Liverpool, in October, 1858, With Evidence Given to the Royal Commissioners on the Sta
Excerpt from Notes on Hospitals: Being Two Papers Read Before the National Association for the Promotion of Social Science, at Liverpool, in October, 1858, With Evidence Given to the Royal Commissioners on the State of the Army in 1857
No one, I think, who brings ordinary powers of observation to bear on the sick and maimed can fail to observe a remarkable differ ence in the aspect of cases, in their duration and in their termina tion in different hospitals. To the superficial observer there are two things only apparent - the disease and the remedial treatment, me dical or surgical. It requires a considerable amount of experience, in hospitals of various constructions and varied administrations, to go beyond this, and to be able to perceive that conditions arising out of these have a very powerful efi'ect indeed upon the ultimate issue of cases which pass through the wards.
It is sometimes asserted that there is no such striking difference in the mortality of different hospitals as one would be led to infer from their great apparent difference in sanitary condition. There is, un doubtedly, some difficulty in arriving at correct statistical comparison to exhibit this. For, in the first place, different hospitals receive very different proportions of the same class of diseases. The ages in one hospital may differ considerably from the ages in another. And the state of the cases on admission may differ very much In each hospital. These elements, no doubt, affect considerably the results of treatment, altogether apart from the sanitary state of hospitals.
In the next place accurate hospital statistics are much more rare than is generally imagined, and at the best they only give the mor tality which has taken place in the hospitals, and take no cognizance of those cases which are discharged in a hopeless condition, to a much greater extent from some hospitals than from others.
We have known incurable cases discharged from one hospital, to which the deaths ought to have been accounted, and received into another hospital, to die there in a day or two after admission.
About the Publisher
Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com
This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.
No one, I think, who brings ordinary powers of observation to bear on the sick and maimed can fail to observe a remarkable differ ence in the aspect of cases, in their duration and in their termina tion in different hospitals. To the superficial observer there are two things only apparent - the disease and the remedial treatment, me dical or surgical. It requires a considerable amount of experience, in hospitals of various constructions and varied administrations, to go beyond this, and to be able to perceive that conditions arising out of these have a very powerful efi'ect indeed upon the ultimate issue of cases which pass through the wards.
It is sometimes asserted that there is no such striking difference in the mortality of different hospitals as one would be led to infer from their great apparent difference in sanitary condition. There is, un doubtedly, some difficulty in arriving at correct statistical comparison to exhibit this. For, in the first place, different hospitals receive very different proportions of the same class of diseases. The ages in one hospital may differ considerably from the ages in another. And the state of the cases on admission may differ very much In each hospital. These elements, no doubt, affect considerably the results of treatment, altogether apart from the sanitary state of hospitals.
In the next place accurate hospital statistics are much more rare than is generally imagined, and at the best they only give the mor tality which has taken place in the hospitals, and take no cognizance of those cases which are discharged in a hopeless condition, to a much greater extent from some hospitals than from others.
We have known incurable cases discharged from one hospital, to which the deaths ought to have been accounted, and received into another hospital, to die there in a day or two after admission.
About the Publisher
Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com
This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.
134 pages, Hardcover
First published January 1, 2010
About the author
Florence Nightingale
217 books118 followersFlorence Nightingale, OM, RRC was an English nurse, writer and statistician. She came to prominence during the Crimean War for her pioneering work in nursing, and was dubbed "The Lady with the Lamp" after her habit of making rounds at night to tend injured soldiers. Nightingale laid the foundation stone of professional nursing with the principles summarised in the book Notes on Nursing. The Nightingale Pledge taken by new nurses was named in her honour, and the annual International Nurses Day is celebrated around the world on her birthday.
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Displaying 1 - 4 of 4 reviews
July 20, 2019
excellent record of her findings and views with respect to military and civilian hospitals.
August 12, 2022
DO NOT WASH your HANDS unless you do THIS she says - OPEN THE F WINDOWS people ! How many times does this woman make this point in every book she writes as a statistician observing outcomes of infection and health before antibiotics ?
Well here is where the CDC messed up REAL BAD on COVID and the general principles of infection control, the reason they STILL don’t classify it as “airborne” like TB and why we constructed every home and building incorrectly.
Whose Dr. Elliot? He messed up real bad sending us on a collision course to modern day health and infection control.
This is THE MOST IMPORTANT BOOK that NO ONE ever read. Her data is conclusive that fresh ground floor air moving like the earths atmosphere, unobstructed is the #1 determinant in infection control and health, even with modern ventilation.
The higher you go up in a building the higher the infection rate and or space per patient needed for the inmates.
Ground floor earths atmosphere in climates cold better than hot, dry better than humid, most importantly how FAST it is moving the breath away from the human including space in cubic feet. The math is in line with MITs aerosol People area surfaces space project.
She brilliantly used “weather science” and fire as a vacuum to get rapid inflow from the TOP OF WINDOWS in cold weather- when a cold front hits a warm front what happens? It rains! So all the DROPLETS from the breath go down in the strata of air and get bigger to be cleaned from the floor and or sucked in from the fire at GROUND level !
A possible mechanism in which this works is the discovery of the microbiome. There is 90% wild yeast and 10% bacteria floating in most ecosystems. In our homes that is reversed. The air is stagnant. Before it enters it’s filtered or heated.
We are fermenting ourselves in a slow bake oven as she brilliantly points out. How could WE MISS this? It’s more important than FOOD well cooked for longevity and health?
Well here is where the CDC messed up REAL BAD on COVID and the general principles of infection control, the reason they STILL don’t classify it as “airborne” like TB and why we constructed every home and building incorrectly.
Whose Dr. Elliot? He messed up real bad sending us on a collision course to modern day health and infection control.
This is THE MOST IMPORTANT BOOK that NO ONE ever read. Her data is conclusive that fresh ground floor air moving like the earths atmosphere, unobstructed is the #1 determinant in infection control and health, even with modern ventilation.
The higher you go up in a building the higher the infection rate and or space per patient needed for the inmates.
Ground floor earths atmosphere in climates cold better than hot, dry better than humid, most importantly how FAST it is moving the breath away from the human including space in cubic feet. The math is in line with MITs aerosol People area surfaces space project.
She brilliantly used “weather science” and fire as a vacuum to get rapid inflow from the TOP OF WINDOWS in cold weather- when a cold front hits a warm front what happens? It rains! So all the DROPLETS from the breath go down in the strata of air and get bigger to be cleaned from the floor and or sucked in from the fire at GROUND level !
A possible mechanism in which this works is the discovery of the microbiome. There is 90% wild yeast and 10% bacteria floating in most ecosystems. In our homes that is reversed. The air is stagnant. Before it enters it’s filtered or heated.
We are fermenting ourselves in a slow bake oven as she brilliantly points out. How could WE MISS this? It’s more important than FOOD well cooked for longevity and health?
June 18, 2023
It's sad that people still haven't figured out today--even after COVID--timeless logical concepts that Florence Nightingale was pointing out in 1859, like the difference between population density and crowding. It's also sad that people had to recently "discover" the importance of ventilation for preventing infection. I hope we don't soon have to rediscover the importance of things like sewers.
It's fascinating to see how she managed to prevent many deaths from infectious diseases before Germ Theory by providing sanitary conditions and measuring outcomes of interventions. Another interesting quality was her humility in visiting hospitals in other countries and going on about how they do certain things much better in Paris or Berlin or wherever.
This text is valubale for those interested in public health, prevention of epidemics, the Sanitarian movement, etc.
Overall however, this is pretty unreadable because it's extraordinarily redundant and mostly outdated and not meant for the general public in any case.
Quotes:
"It will be seen at a glance, that in every such case and in every such example, the 'infection' is not inevitable, but simply the result of carelessness and ignorance. As soon as this practical view of the subject is admitted and acted upon, we shall cease to hear of hospital contagions."
"The officer of health of towns ... does not do the work of the physician or surgeon; and on the other hand, you do not send for your physician or surgeon to drain your street."
It's fascinating to see how she managed to prevent many deaths from infectious diseases before Germ Theory by providing sanitary conditions and measuring outcomes of interventions. Another interesting quality was her humility in visiting hospitals in other countries and going on about how they do certain things much better in Paris or Berlin or wherever.
This text is valubale for those interested in public health, prevention of epidemics, the Sanitarian movement, etc.
Overall however, this is pretty unreadable because it's extraordinarily redundant and mostly outdated and not meant for the general public in any case.
Quotes:
"It will be seen at a glance, that in every such case and in every such example, the 'infection' is not inevitable, but simply the result of carelessness and ignorance. As soon as this practical view of the subject is admitted and acted upon, we shall cease to hear of hospital contagions."
"The officer of health of towns ... does not do the work of the physician or surgeon; and on the other hand, you do not send for your physician or surgeon to drain your street."
June 8, 2024
This felt like the nursing version of Leviticus. Sorry, Flo.
Displaying 1 - 4 of 4 reviews