The Sun.
London, England, 1858-01-14 00:00:00

*VENTILATION OF HOSPITALS.

To THE RIGHT HON. THE BARL OF GALLOWAY,
PRESIDENT OF THE GENERAL LYING-IN Hos
?ITAL.

36, Berkeley-square, W.

My Lord,—ln resigning the office of physician
at the General Lying-in Hospital, which I have
held for upwards of 20 years, I deem it only just to
offer to your lordship an explanation of my reasons
for taking this step.
On several occasions I have felt it necessary to
differ from the committee on the subject of Dr.
Reid's system of ventilation, which was established
in 1842, which has produced the most favourable
effects upon the sanitary condition of the hospital,
and which without any just reason has been dis-
continued.
A short statistical summary of the mortality at
the General Lying-in Hospital, without and with
this plan of ventilation, will best explain my posi-
tion. I may also add that the accuracy of the sub.
joined numbers is beyond cavil, having had them
corrected and verified by an experienced calculator.
From Jan., 1837, to Aug., 1841 (when the hos-
pital was closed for the purpose of establishing Dr.
Reid's system of ventilation), 802 women were de
livered, of whom no less than 61 died, showing a
mortality of 76.05 per 1,000.
The hospital was reopened in April, 1842, but
by the determined opposition of the present matron
and the nurses under her the new ventilation was
rendered worse than useless—the valves were regu-
larly closed the moment my back was turned ; and
from April, 1842, to the end of March, 1843, 19
women died out of the 209 who were delivered
during that period—making a mortality of 90.90
per 1,000.
The following April (1843) two of my own pupils
at St. Bartholomew's became house surgeons at the
General Lying-in-Hospital, and resolutely carried
the ventilation into full activity.
The mortality ceased instantly, and for a period
of seven years the success as regards the health of
the patients and of their children was most extra-
ordinary. Of 1,661 patients delivered during this
period only 8 died, and one of these was from an
accident, or at the rate of 4.31 per 1,000, the
greatest amount of success which has ever occurred
at any lying-in hospital, whether in this country or
on the continent ; and yet other circumstances were
not peculiarly favourable during these years, the
hospital was much fuller than it had ever been be-
fore, and this period was not remarkable for the
general healthiness of London.
In April, 1850, the committee determined to dis-
continue the ventilation, and from this time to
May, 1855, 30 women died in childbed, or at the
rate of 25.90 per 1,000. In May, 1855, after violent
opposition, I succeeded in obtaining permission to
have the ventilation renewed, and hoped that the
experience of former years would have allayed every
prejudice against it.
In February, 1857, Mr. Grissell, who bad been
one of the most active of the committee in stopping
the ventilation in April, 1850—undeterred by the
frightful mortality before it was established, and
uninfluenced by the extraordinary success during
the seven years when it was in activity, neither
warned by the fatal results which had followed its
discontinuance for five years—ordered a large hole
to be made into the file shaft, by which its action
on the air of the hospital was effectually cut off ;
end tbis he did without having such a measure
moved, or seconded, or put to the committee in the
regular way, and in spite of the disapproval of the
senior physician (myself) who was standing by.
Puerperal fever again appeared towards the end of
the summer, and feeling that it was useless to make
any further appeal to the committee, I considered
it my duty to apply to Dr. Odling, the officer of
health for Lambeth, who, on inspecting the hos-
pital and reporting its state to the vestry board,
was directed to write to the governors of the
General Lying-in Hospital. Aspecial meeting was
immediately summoned, and a vote of censure,
moved by Mr. Grissell, was passed upon me for
"calling in Dr. Chiang.' That vote of censure
troubles me not. I have done my duty to my poor
patients, and if four years and seven months with-
out the ventilation show 61 deaths, and seven years
. _

with it only eight, it may be fairly said that but
for the ventilation, caeteris paribus, we should have
lost 93 women, instead of that magnificent result
of only eight ; and in the succeeding five years,
instead of losing 30 by unwarrantably cutting off
the ventilation, we should have lost only five.
This is not a solitary instance of the success of
Dr. Reid's ventilation in a lying-in hospital. At
Copenhagen the mortality from puerperal fever
was even worse than at the General Lying-in
Hospital, but the new hospital which has been
built with this system of ventilation from plans fur-
nished by myself has shown results as striking and
gratifying as in London.
Such overpowering facts establish the certainty
that a great number of women will die at the Gene-
ral Lying-in-Hospital if this system of ventilation
be stopped, and that a most unusual healthiness of
the patients and singularly few deaths occur when
it is in action. The wilful destruction of it, there-
fore, in the face of such evidence becomes an act
verging so closely into oue of a criminal character
that I will not lend myself, directly or indirectly, to
anything of the kind ; and as to the vote of censnre
against me which Mr. Grissell proposed and carried,
it merely amounts to an act of defiance to the
ordinary principles
feelings and of humanity.
In stating these details to your lordship I fulfil
the
Tohbej eoc of
officers
cermytt s
of health
r
possess no powers beyond
those of pointine, out error, and reasoning where
reawn exists. The 6 Secretary of State for the Home
Department " has no power to interfere." It is
therefore my purpose to use this letter to your
lordship as a means of appeal t 3 that great organ
of public opinion which is ever ready to defend
"right against might." I have the honour to be,
my lord, with great respect, your lordship's Obedi-
ent servant,