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Excerpt from Report of Cases of Hospital Gangrene Treated in Douglas Hospital, Washington, D. C
This man steadily improved, recovered with a good stump, and was finally sent to New York to be mustered out of the service.
I will conclude this brief clinical history by a short summary.
Etiology - This disease made its appearance in a wooden pavilion, con taining fifty beds, most of them occupied by very seriously wounded men unable to leave the building, with a cubic capacity of 1050 feet to each bed, heated by ordinary radiating coal stoves, devoid of any system of ventila tion, and having no ingress for pure air, nor egress for foul, except through the windows and doors. This want of pure air was combined with a want of strict police, and a careless and unscientific method of dressing the wounds, rancid ointments being largely used instead of the ordinary water dressing.
No case of gangrene was received as such into the hospital, nor is it probable that it was otherwise introduced.
Although a majority of the cases in this ward escaped gangrene, yet there was evidently some depressing agent at work, since but few wounds healed rapidly. The patients seemed also dispirited, homesick, and moody. Those who were attacked were removed to a ward in the brick house, where they were isolated, and at the same time placed under better hygienic in¿uences.
Two shafts for foul air, connected with the stoves, which withdrew the foul air from near the ¿oor, had recently been placed in the ward by order of the surgeon-general. This was not considered sufficient, and the long doors of these foul air shafts were kept constantly Open. Strict attention to cleanliness and careful dressing was enforced, and, what might have been a very severe epidemic, was confined to few cases. The upper row of win dows were rehung in such a manner as to direct the currents of cold air admitted in a line with the roof, and, to crown all, the ridge ventilation was applied to the pavilion.
These precautions, and an improvement in the diet of the house, giving more vegetables and antiscorbutics, enabled me to prevent any further seri ous manifestations.
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