2. A form of construction unsuited for hospital purposes.
3. No means of removing outside the building febrile or other cases of puerperal diseases from the vicinity of patients recovering after delivery.
Since 1856, notwithstanding the great improvements, the death-rates per 1,000 have been 12·2, 8·8, 81·2, 70·3, 54·2, 39·2, 15·5, and so on: in several years very considerably larger than the mortality which led to the closing of the lying-in wards in King’s College Hospital. These varying deaths lead to the exercise of much caution in drawing conclusions as to their causes; but the main fact remains, namely, there are the death-rates, and they are many times greater than occur among London poor women delivered at home.
Midwifery Wards, King’s College Hospital.—The following plan shows the provision which existed for training midwifery nurses at King’s College Hospital.
MIDWIFERY WARDS, KING’S COLLEGE HOSPITAL.
(Plan of Third Floor.)
A, A. Accouchement Wards, used alternately. B. Recovery Ward. C. Contains Linen Presses, and Infants’ Baths, &c., for Ward use. D. Superior’s Bed-room. E. Midwife’s Room. F. Post-mortem Theatre. G, G. General and Provision Hoists. K. This roof is not higher than the basement. x. Ventilating openings on a level with upper part of opposite window. a, a, a, a. Doors cutting off communication with either Accouchement Ward when necessary. b. No. 4 Ward.
The plan shows the relation of the delivery wards to the recovery ward, and to the other parts of the hospital; to the lecture room, post mortem theatre, &c. The main defects in the construction are: the back to back wards; proximity of these wards to the general wards of the hospital; the large staircase, common to both sets of wards, although its size and openness, and the windows opposite each other and on each floor, ensured ventilation, and separated the respective blocks; the position of the post-mortem theatre, the smell from which, as stated on the best authority, could be distinctly detected in the wards. As already stated, students were admitted from other parts of the hospital to the midwifery wards.
RESULTS OF IMPROVED LYING-IN WARD CONSTRUCTION.
A few instances of improved lying-in ward construction, together with the death-rates in these establishments, will next be given.