Found this in the MD archives and thought that most of us have ancestors
that were possibly hospitalized not only in Baltimore, but I would imagine
in any hospital, would find this article interesting and shudder.. We have
sure come a LONG way baby...... jd. <><
Medical care in the city of Baltimore, MD 1752-1919
From its earliest beginnings, Baltimore was a city under siege.
residents were successful at defeating British invaders, it was
enemies - yellow fever, consumption, typhoid, and cholera - that repeatedly
struck at the heart of the city. The urban poor were particularly
vulnerable. Inadequate diets, dense housing, poor sanitation and a variety
of environmental ills - lumped into the category of "public nuisances" -
reduced their chances of fending off infection. At the same time, the
institutions charged with their care were themselves victims of inadequate
funding, poor design, and labored under misconceptions concerning the cause
and treatment of disease.
Although the city experienced reoccurring outbreaks of cholera, yellow
fever, smallpox, and other infectious diseases, the fear of hospitals was so
great that most cases were treated at home until the patient was near death.
Nineteenth century public hospitals, both in Europe and the United States,
were viewed as a medical means of last resort. Hospital wards were generally
squalid, overcrowded, and badly ventilated. The insane, blind, and crippled
were housed together with the sick. Since private hospitals often refused to
admit contagious or incurable cases as well as those deemed morally
unworthy, the local almshouse was usually the only source for medical care.
In almshouse infirmaries, little was done to quarantine patients with
infectious diseases, who, in turn, could potentially contaminated attending
doctors, nurses, and other inmates. Nor were the sexes segregated, and
prostitutes, often suffering from a variety of illnesses themselves, set up
business in the wards with little interruption. A disproportionate number of
cases were chronic, lingering illnesses, such as lung, heart, and kidney
ailments, whereby the patient neither died nor recovered. Patients may have
to share beds, sometimes lying among the dead for hours before the corpses
were removed. Bed linens were infrequently changed and a new patient might
rest in the last patient's sheets. In the lying-in wards, women had a better
chance of surviving childbirth by birthing at home with a midwife than by
giving birth in a hospital.
Improvements in the medical care of Baltimoreans was dependent upon the
professionalization of doctors and the institutionalization of medical
education advocated by the University of Maryland School of Medicine and
practiced in its clinical arm, the Baltimore Infirmary. The establishment of
the Baltimore Infirmary permitted medical students to receive first-hand
experience in the diagnosis and treatment of patients, learning through
observation and hands-on experience rather than lectures and readings. The
introduction of clinical experience in the teaching of medicine was a
significant step. Incorporating clinical education into the medical
curriculum and expansion of teaching privileges in hospitals across the city
produced doctors with practical experience in anatomy, clinical diagnosis,
and treatment of disease. This shift in medical education and practice gave
rise to hospitals that were no longer places to die, but havens to get well.