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LETTER FROM PHILADELPHIA.
PHILADELPHIA, MARCH 15, 1869. EDITOR OF THE WESTERN JOURNAL OF MEDICINE-Dear Sir: As mortuary and hospital reports are always interesting to the profession, I venture to commence my letter with brief extracts from the annual reports of the Board of Health, and Officers of the Philadelphia and Pennsylvania Hospitals, issued for the year 1868.
The first report exhibits the mortality of the city, as follows:
7,674 Females, Boys, Girls,
3,652 Among the adults, the largest number of deaths occurred in the month of April-seven hundred and nineteen.
The month of July was the most fatal to the children, as indicated by the great number of deaths occurring during that month-one thousand, two hundred and seven.
July shows the highest number of deaths-one thousand, nine hundred.
November the lowest number-eight hundred and seventy-eight.
11,080 Foreign, People of color,
769 Unknown, Among the diseases enumerated as "causes of death,
"“Phthisis" stands first on the list, contributing to the adults one thousand, five hundred and eighty, and to the minors two hundred and sixty-six. Then follow,
INFLAMMATION OF THE Lungs-
385 DISEASES OF T&B HEARTAdults,
58 Among fevers, typhoid is the most prominent in the adult class scarlet with the children. Coup de soleil, one hundred and four. Casualties, one hundred and sixty-eight. Suicides, twenty-nine. Murders, twenty
These close a list embracing fifty diseases and conditions given as causes of death.” The two last do not speak well for the social and moral condition of the inhabitants of the “City of Brotherly Love."
Turning to the hospital reports, we have that of the Philadelphia Hospital, by the recording clerk, incorporated with the report of the Board of Guardians of the Poor, this institution being a department of the Blockley Almshouse. The Almshouse is one of the largest eleemosynary institutions in the country, and embraces the Out-Door Department, Out-Ward Department, Philadelphia Hospital, Philadelphia, Hospital for the Insane, and the Children's Asylum. ALXSHOUSENumber receiving out-door relief,
144,542 Number admitted into the House during the year,
38,627 IXBASE DEPABTWENTNumber treated during the year,
224 Discharged as cured, improved and unimproved, Died,
680 HOSPITAL DEPARTIENT
808 Mortality for the entire hospital, nine and seventeen-one hundredths per cent. Excluding the foundlings and the phthisis, it is reduced to seven per
cent. The Pennsylvania Hospital Report is a more elaborate document, and is presented to the public in the form of a handsome octavo volume, bound in cloth. The plan adopted in the preparation of the report is the same as that of the London hospitals, and I think this hospital is the only one in this country issuing its report in this way.
This volume, the second thus far issued, is edited by Dr. J. M. DaCosta and William Hunt, members of the Medical and Surgical Staff, and is dedicated to Prof. Geo. B. Wood, M. D., who was for many years physician to the institution. Besides "Abstract of Cases and Statistics,” it contains papers of a practical character, based chiefly on observation made at the hospital. I hope at some future day to notice at length this very valuable work. At present, time and space only permit me to commend it to the attentive perusal of all the members of the profession who are interested in the development of our hospitals, and in the proper utilization of the vast amount of material they contain.
From the statistics for the year 1867–68, we learn that the number of patients treated was one thousand, nine hundred and fifty-eight. Of the patients discharged, the proportion cured was,
71.43 per cent. " relieved,
10.99 11 removed without material improvement,
7.27 discharged for misconduct or eloped,
8 53 Cases of accidental injury treated during the year,
Since the establishment of the Hospital in 1752, there have been admitted into it eighty thousand, nine hundred and sixty-eight patients, of whom fifty-two thousand, four hundred and fifty-four were cured, and seven thousand, seven hundred and eight died. During the year, a new Clinique has been erected, connected to the main building by a short covered passage way. A building designed especially for clinical instruction has been long needed, and the one erected, though defective in some very important particulars, is a decided improvement upon the contracted quarters in the “cupola" of the hospital building.
I have on my table a monograph by Dr. Addinell Hewson, "On the influence of the weather over the results of surgical operations, and on the value of the barometer as a guide in the choice of the time for and the prognosis in such operations as shown by the results of immediate amputations, during a period of thirty years in the Pennsylvania Hospital.” This is certainly a new field of investigation, and the conclusions arrived at are both novel and interesting. An examination of the tables prepared by Dr. H., shows that the most unfavorable results have followed operations performed in the months of December and May, two months almost as much antipodal of each other, as regards temperature, as any other two in the whole year. From the fatal effects of shock, we have December also taking the lead, and
immediately followed by November, June and May, as giving the next highest in order. For deaths from pyæmia, etc., we have the last months of the summer and spring terms giving the highest rates for
As to saccesses, the month which stands preëminent in total results, is that of October, then comes January, and then April. October, eighty-nine per cent.--April, over eighty-six per cent.
From the effects of shock, it will be observed that there was not a single death amongst all the cases operated on in the months of October during the whole thirty years. The months which follow this as yielding the least mortality from this cause, are September, August, January, March and April.
From fever, pyæmia, etc., we find the months of February presenting the same clean record that October did for shock, and after it we have the months of November, December and January giving the next least mortality.
The conclusions are, that fatal results from shock occur in a constant ratio with the dryness of the weather, and that those from fever, pyæmia, etc., bear a direct ratio to the opposite state.
In connection with this subject, it may be interesting to note the fact that the mean temperature of the past forty-four years, as shown by the records kept at the Pennsylvania Hospital by Dr. John Conrad, is fifty-three and one-half degrees. The warmest year was 1828, fifty-five and three-fourth degrees; and the coldest, 1837, forty-nine degrees.
During the past two weeks, the various medical institutions of this city bave held their annual commencements. I think that we have nine of all kinds—two Eclectie, two Homeopathic, one Woman's, two Dental, the Jefferson College and the University of Pennsylvania. It is safe to assert that four hundred and fifty degrees were conferred by these different institutions,
At the seventeenth annual commencement of the Women's Med. ical College of Pennsylvania, the degree of Doctor of Medicine was conferred upon fifteen graduates. Latterly, much interest has been manifested in the question of the status of female physicians, and the relations which should exist between them and members of the profession. If it is true, as asserted, that three of the most prominent phy, sicians of this city, one of them a distinguished professor, have accepted positions as consulting physicians to the hospital in charge of the Wo. men's Medical College, then this fact must be acceptǝd as an evidence
of a decided reaction in public opinion. It is also stated that the reason given by these gentlemen for their action is, as they are unable to prevent the movement, the next best thing for them to do, is to guide it properly. Certainly very good logic if the premises are correct.
Leaving the entangling question of women's rights, I return to note briefly the incidents connected with the annual commencements at the University of Pennsylvania and the Jefferson Medical College. As has lately become the custom, and a very good one it is, the commencement exercises of the University were held in the Academy of Music. The degree of Doctor of Medicine was conferred upon one hundred and twenty-eight graduates, representing twenty-three States, and the valedictory address was delivered by Prof. Alfred Stillé, M. D. This address, as with everything which emanates from the pen of the distinguished professor, was an able production and well suited to the occasion.
The forty-fourth annual commencement of the Jefferson Medical College was held at the Musical Fund Hall. The degree of Doctor of Medicine was conferred upon one hundred and twenty-six graduates, representing twenty-three States. The valedictory address, by Prof. Samuel Henry Dickson, was one of the gentleman's happy efforts, graceful and learned. The alumni of the college will fully appreciate his remarks upon the retirement of Prof. Robley Dunglison. I give you the following extract:
" Many of you have missed personally, and all traditionally, during the past session, as we lament to miss now from among us, a once familiar face, a manly presence, full of intelligence and dignified simplicity. The place which he of whom I speak, long occupied, shall know him no more forever; but he has left imperishable records of worth and usefulness as teacher, author and administrator ; hon. ored and loved as instructor; “primus inter pares,” in the midst of his colleagues. The annals of our school contain no name more distinguished than that of Robley Dunglison ; none more dear to those who have had the happiness to enjoy his society and profit by his wise counsels, his frank cordiality, liis kindly and courteous manner. We offer him the homage of our respectful remembrance in his patient retirement, our profound sympathy with his suffering."
The classes this year were not as large as usual, owing, no doubt, to the re-opening of the schools of the south and west.
For the past two or three years, summer courses of lectures have been given at the University and Jefferson College. At the former, the subjects lectured upon are, Zoology and Comparative Anatomy, Botany, Mineralogy and Geology, Hygiene, and Medical Jurisprudence and Toxicology. . In