In 1863 it was 70·3 per 1,000.
| Table XI.—Mortality per Thousand among Lying-in Women at the undermentioned Parisian Hospitals during the Year 1861. (Abstracted from ‘Statistique Médicale des Hôpitaux,’ 1861.) | ||||
|---|---|---|---|---|
| Hospital | Total Deliveries | Mortality per Thousand | ||
| Puerperal | Non-Puerperal | Total Deaths | ||
| Hôtel Dieu | 1,057 | 43·5 | 16·1 | 59·6 |
| Pitié | 468 | 72·6 | 34·2 | 106·8 |
| Charité | 253 | 154·2 | 39·7 | 193·7 |
| St. Antoine | 350 | 71·4 | 34·3 | 105·7 |
| Necker | 234 | 29·9 | 29·9 | 59·8 |
| Cochin | 56 | 142·9 | 35·7 | 178·6 |
| Beaujon | 276 | 43·5 | 3·6 | 47·1 |
| Lariboisière | 782 | 69·1 | 15·3 | 84·4 |
| St. Louis | 802 | 58·6 | 13·7 | 72·3 |
| Lourcine | 41 | 24·4 | 24·4 | |
| Cliniques | 875 | 75·4 | 34·3 | 109·7 |
| Maison d’Accouchements | 2,115 | 99·8 | 12·8 | 112·5 |
| Total | 7,309 | 75·2 | 19·8 | 95·1 |
| Table XII.—Mortality per Thousand among Lying-in Women at the undermentioned Parisian Hospitals during the Year 1862. (Abstracted from ‘Statistique Médicale des Hôpitaux de Paris,’ 1861, 2, 3.) | ||||
|---|---|---|---|---|
| Hospital | Total Deliveries | Mortality per Thousand | ||
| Puerperal | Non-Puerperal | Total Deaths | ||
| Hôtel Dieu | 975 | 35·8 | 9·2 | 45·1 |
| Pitié | 462 | 45·4 | 10·8 | 56·2 |
| Charité | 270 | 62·9 | 25·9 | 88·8 |
| St. Antoine | 311 | 61·0 | 19·2 | 80·3 |
| Necker | 190 | 52·6 | 21·0 | 73·6 |
| Cochin | 24 | 41·6 | 83·3 | 124·9 |
| Beaujon | 257 | 38·9 | 19·9 | 58·8 |
| Lariboisière | 816 | 34·3 | 13·5 | 47·8 |
| St. Louis | 704 | 79·5 | 8·5 | 88·0 |
| Lourcine | 45 | 22·2 | 22·2 | |
| Cliniques | 769 | 79·3 | 14·3 | 93·6 |
| Maison d’Accouchements | 2,204 | 63·5 | 11·3 | 74·9 |
| Total | 7,027 | 56·7 | 12·9 | 69·7 |
| Table XIII.—Mortality per Thousand among Lying-in Women at the undermentioned Parisian Hospitals during the Year 1863. (Abstracted from ‘Statistique Médicale des Hôpitaux’, 1863.) | ||||
|---|---|---|---|---|
| Hospital | Total Deliveries | Mortality per Thousand | ||
| Puerperal | Non-Puerperal | Total Deaths | ||
| Hôtel Dieu | 925 | 26·7 | 4·1 | 30·8 |
| La Pitié | 544 | 44·1 | 1·8 | 46·0 |
| Charité | 256 | 66·4 | 19·5 | 85·9 |
| St. Antoine | 410 | 63·4 | 11·6 | 78·0 |
| Necker | 232 | 38·8 | 21·6 | 60·3 |
| Cochin | 68 | 73·5 | 14·7 | 88·2 |
| Beaujon | 313 | 19·2 | 12·8 | 31·9 |
| Lariboisière | 870 | 31·0 | 9·2 | 40·2 |
| St. Louis | 871 | 23·0 | 9·2 | 32·1 |
| Lourcine | 43 | 27·9 | 27·9 | |
| Clinique | 751 | 30·6 | 18·6 | 49·3 |
| Maison d’Accouchements | 2,006 | 130·1 | 7·4 | 137·6 |
| Total | 7,289 | 60·6 | 9·7 | 70·3 |
CLASSIFICATION OF CAUSES OF MORTALITY IN LYING-IN INSTITUTIONS.
The next thing is to endeavour to show to what causes these death-rates are to be attributed. Unfortunately Dr. Le Fort’s tables do not enable us to distinguish the causes of death. But the data supplied by British and Parisian hospitals allow the causes to be classified to a certain extent under the heads adopted by the Registrar-General in his Reports.
A classified arrangement of this kind is given in Table II., and may be resumed, with the view of showing the enormous differences in death-rates among puerperal women under different conditions, as follows:—
| Mortality per 1,000. | ||||
|---|---|---|---|---|
| Puerperal diseases | Accidents of childbirth | Puerperal diseases and accidents of childbirth | ||
| All England, 13 years | 1·61 | 3·22 | 4·83 | |
| England (healthy districts), 10 years, 312,402 deliveries | 4·3 | |||
| England, 11 large towns, 10 years, 1,402,304 deliveries | 4·9 | |||
| Liverpool workhouse | 3·4 | 2·2 | 5·6 | |
| 27 London workhouses having deaths | 4·1 | 2·1 | 6·2 | |
| 8 military female hospitals | 3·9 | 3·4 | 7·3 | |
| Queen Charlotte’s Lying-in Hospital | 14·3 | 5·3 | 19·6 | |
| King’s College Hospital lying-in ward | 29·4 | none | 29·4 | |
| 12 Parisian hospitals | { 1861 | 75·2 | ||
| { 1862 | 56·7 | |||
| { 1863 | 60·6 | |||
We have already seen, as a result of Dr. Le Fort’s tables, that the mortality among women delivered at home, as deduced by him, is 4·7 per 1,000; while in the hospital it is 34 per 1,000, or nearly 7½–fold. Making any reasonable allowance for inaccuracy in the data, still we can hardly escape from his conclusions any more than we can rid ourselves from the consequences which follow from the data given above. We must confront the question called up by the data taken as a whole, viz., What can be the reason of this ascending scale of fatality shown on Table VIII.? Why is it that these death-rates from all causes in childbirth, beginning at 5·1 per 1,000 for all England (town and country), successively become, among the same people 9·, 10·9, 14·3, 25·3, 33·3; and if we cross the channel, why should they mount up to 69, 70, and 95 per 1,000?
Again, why should fevers and inflammations of the puerperal class, which, as we have seen above, give a death-rate for all England of 1·61 per 1,000, mount up in English hospitals to 3·4, 4·1, 14·3, and 29·4? There must be some reason, besides the fact of childbirth, why diseases and accidents of this condition should be 4 times more fatal in a London lying-in hospital, and 15 times more fatal in Parisian hospitals, than they are in towns of England. What, then, are the immediate causes of these excessive death-rates?