4. One class of attendants devoted indiscriminately to all classes of inmates.
5. As already mentioned, women admitted and retained within the walls of the establishment before and after the time simply required for delivery and convalescence.
Lastly, an enormous death-rate mainly from puerperal diseases.
Hôpital de la Clinique, Paris.—This establishment is part of the hospital for clinical instruction, close to the buildings of the École de Médecine. The hospital consists of a parallelogram with a central court, containing not only the clinical surgery wards, but also an amphitheatre devoted to anatomical studies, with a mean number of fifty corpses in the course of dissection.
There are six wards devoted to the midwifery department, arranged in a complicated manner, partly across the corridor, and partly on each side of the corridor, all of them entered from a central passage lighted by the open doors of the wards along the sides. They contained 54 lying-in beds. From 800 to 900 deliveries took place here annually. 18 to 20 days appear to be the average stay. The beds must, therefore, have been pretty constantly full.
The wards devoted to women who have been delivered communicate freely with one another by open doors. The beds are curtained, and the curtains are washed only once in six months, even though the occupants of the bed may have died of puerperal fever. The beds are of iron, and are provided with a spring mattress, over which is a wool mattress. The latter is removed after each delivery, cleansed, and renewed. There is no infirmary for diseases; whether cases of puerperal fever or others, all are treated in the beds in which they are placed after delivery.
The female staff performs its duty to all classes of cases.
Students entered upon the roll for midwifery practice are called into the wards from other parts of the establishment by signals placed in a window.
It is quite unnecessary to search for any more recondite causes of the past excessive mortality of this establishment than these simple facts.
