CHAPTER XI.
Hospital Hygiene
Some sage has remarked that men and women are doomed, from birth to the grave, to combat three things—disease, dirt and the devil. With a great many of the human race, the effort put forth to oppose either one of the D’s is so weak that it could scarcely be called a combat. The D’s are on hand, when the first breath is drawn, and the unfortunate individual weakly yields to force of circumstances. If he does not succumb to their influence early in life, he drags through an existence somehow and calls it living. But in a hospital, if the health of the workers is to be preserved, if the hopes of those who come as seekers of health are not to be defeated, if life for any of its inmates is to be considered safe, then nothing less than an unceasing war, a hand-to-hand combat with the three D’s must be maintained.
Prevention of Disease
Preventive medicine and preventive nursing are each year assuming a larger place in the study not only of those who deal with disease, but of the public in general, and in no place is such knowledge of greater importance than in a hospital. To Florence Nightingale we are under a debt of gratitude for giving to the world some of its first and best lessons on hospital sanitation. When she, with her corps of English nurses, entered the huge hospital in Scutari in 1856 and began her work among the six thousand wounded soldiers, the disorder and filth and consequent suffering was appalling. She shocked the propriety of some of the army officials beyond measure, but she saved lives. She transformed the hospital, and the haughty officials who on her arrival in astonishment had remarked: “Fancy! Some women have come to the hospital! A Miss Nightingale, with a force of assistants. Was anything ever more improper than women in such a place?” learned in less than a week some lessons they were sadly in need of from that self-same woman. Much of her teaching on hospital sanitation we have not yet outgrown, in spite of all the progress we have made.
In the average home, under the best conditions, the skill of the intelligent housewife is taxed to the utmost to prevent disease from invading its precincts. How much the more vigilance is required in a hospital with all its adverse influences to contend with? Many years ago a medical officer of a health department in England, in speaking on this subject, said:
“That which makes the healthiest house makes likewise the healthiest hospital; the same fastidious and universal cleanliness, the same never-ceasing vigilance against the thousand forms in which dirt may disguise itself, in air, in soil and water, in walls and floors and ceilings, in dress and bedding and furniture, in pots and pans and pails, in sinks and drains and dust-bins; it is but the same principle of management, but with immeasureably greater vigilance and skill; for the establishment which has to be kept in such exquisite perfection of cleanliness is an establishment which never rests from fouling itself; nor are there any products of its foulness, not even the least odorous of such products, which ought not to be regarded as poisons. Above all this applies to the fouling of the air within hospital wards by exhalations from the persons of the sick. In such exhalations are embodied the most terrible powers of disease, the spreading flames, as it were, of some infections and the explosive fuel of others; and any air in which they are allowed to accumulate soon becomes a very atmosphere of death.”
The subject of hospital sanitation is so large, so many-sided, that to do it justice in the space allotted is impossible. It involves a consideration of the site of the hospital and the plans, the separation of the departments, the materials used in its construction, its ventilating system, its plumbing and sewerage connection, its food and water supplies, its facilities for isolation of infectious diseases, for disinfection, for disposal of the waste and refuse from the various departments, and its arrangement for living conditions for those on whom the responsibility of carrying on the work of the hospital involves.
Sanitary Kitchens
Pure Food