Hospitals: Their History, Organization, and Construction. Boylston Prize-Essay of Harvard University for 1876

Hospitals: their history, organization, and construction – is an essay which was written by Walker Gill Wylie, M.D. and published in 1877 as Boylston prize-essay of Harvard University for 1876. Since there may be people who consider the subject of this essay, especially the chapter on Construction, somewhat outside the scope of a medical practitioner, perhaps a word about the circumstances that led to its writing may be out of place. Having worked as a surgeon on the Resident House-Staff of Bellevue Hospital, a large hospital pauper-hospital of the city, the author had a great opportunity to see how poor nursing and faulty construction affect the well-being of patients. The hospital building, originally an old prison and almshouse, was added and is now a massive stone structure with three floors and a basement. The chambers were separated from each other only by partitions enclosing toilets and bathrooms, which had no ventilation, except that they opened into the chambers. In some cases, there were only six windows per ward with twenty beds. The sanitary condition of the hospital was shocking, despite the fact that the wards seemed to the visitor to be clean and tidy. The author saw how on duty in the wards, patients die from septic diseases, suffered in the wards after the slightest surgery or injury. Forty to sixty percent of all limb amputations have been fatal. After becoming a member of the Standing Committee on Hospitals of the New York State Charities Aid Association in the spring of 1872, the author devoted his spare time to study the subjects of skilled nursing and hospital construction, spending the summer overseas to that end. The article, which the author read to the Association in December 1873, presented essentially the same plan for the model department that is described in this essay. The association requested publication of the article, but the author felt that this topic warranted further study. In February 1876, the chapter " History of the Origin and Development of Hospitals: their Progress during the Century of the American Republic" was read at the New York Academy of Medicine, after which, deciding to compete for the Boylston Prize, during March, the author hastily wrote the rest of the essay and sent it to Cambridge under the terms of April 3, 1876. The author does not present this book as a complete work on hospitals. To better understand all the details of internal management, the author refers his readers to the "Handbook for Hospital Visitors," Document No. 13, State Charities Aid Association.