The New York herald. [volume] (New York [N.Y.]) 1840-1920, 1851-02-12

his other dates, not touching the concerns Of this
commission, should be paid from some other
quarter.
The greatly decreased proportion of patients at
the Marine Hospital since the change OF that
establishment, from general hospital for the re-
cepton OF all who had paid hospital or commute
ton money, 10 a quarantine establishment for nfec-
tiOus or contagious diseases, has led the Commits
sioners to the belief that some economical changes
might be made by law, without detrment to the
The number of the assistant physicians Is now
6xed permanently at four throughout the year,
whilst the actual service for considerable portion
OF the year can be competently discharged by the
chief, with two assistants.
Such a modification OF the law respecting the
Marine Hospital might be made as TO reduce the
fixed number OF assistants to two, with the au.
thority to employ increased medical aid in case OF
II is also submitted, by majority of the Com
missioners, whether reduction may not be pro.
perly made in the salary of the physician of the
Marine Hospital.
EMlGRANr REFUGE AND HOSPITAL DEPARTMENT on
WARDS ISLAND.
After the new organization of the Quarantine
Department at Staten Island, under the act of
April lS49, which restricted the reception OF pa
tents into the Marine Hospital mainly to those
afflicted with infectious or contagious diseases, the
Increase ofmedical and surgical patients at Wards
Island, frequently amounting to one halt the num-
Der Of emgrants received there, required corre-
spending increase in the medical service of the
emigrant hospital on that island This demand
was at first met, was stated in our last annual
report by the division Of the duties OF supernten
dent from the medical CHI arge land the appointment
Of resident physician in chief, with such medical
time might render necessary. This system went
into operation in June, l849, and was continued
above year. But maj GRITTY OF the commission
ers became gradually convinced that whatever
might be the fidelity or ability with which it was
administered, it could not supply the efficient
vice required hya hospital unsurpassed in number,
and in variety OF cases, by any establishment in
this country, containing not less than six hundred
patients. and generally from seven to nine hun
dred, requiring the aid of medical and surgical
skill in every department of medical science. For
a small sanitary establishment, or in specially
devoted to any single class Of maladies, such as
insanity, or the diseases Of the eye, the plan of
single head, it was admitted, had its advantages
and efficiency. But they thought that the variety
of diseases, and numerous patients under their
charge demanded, 10 order to receive the full be-
neft of the present advanced state of professional
science, variety of ability and experience, medi-
CAL surgical obstetrical, or relating to diseases of
the eye or other organs, which have within the
aet thirty years be separate branches of study
such skill as il is impossible to find combined in
any one individual.
The experience of several of the largest and best
managed hospitals of New York, and other great
cities, has shown that by. appointing sufficient
number of practising physicians and surgeons 10
divide the higher hospital duties among them in
rotation, without sacrificing or abandoning their
private practice, professional talent of higher or
der in every branch, could be commanded for the
service ct the poor and destitute The regular
visits OF such body of directing the
practice in each case, or for the performance Of
surgical operations aided by the constant attend
ance of younger but well educated physicians,
constantly resident in the establishment, thus Sc
cure to the humblest class of patients degree Of
medical care and skill noways inferior to that
bestowed on the most opulent patient.
Such is the arrangement which has prevailed,
with rIniv haiti fay han ffu
years in the New York hospital in this city, and
which has been more recently introduced into the
Bellevue hospital. A similar plan has for years
been followed in the best institutions of this in
Philadelphia and Boston, well as in many of the
largest and best governedpublic hospitals of Paris,
London and Dublin.
When hospitals, thus managed, are stu ated in
the midst of great city, its immediate vicinity,
go that the required attendance can be given by
physicians without a serious interference with
their private practice IT is found, that the profess
sional standing given by connection with grea.
public institution, the experience there gained, and
the facilities OF public and private instruction
afforded, render such places 80 desirable, that they
are accepted and often eagerly sought for, without
any direct pecuniary compensation.
After deliberate examination of the operation o
this system in several in situations, the Commits
sioners determined to apply it to the Wards Island
hospital.
The order of visitation has been so arranged a:
to give the attendance Of at least two physicians
and one surgeon every day; the time spent by then
must Of course vary according to the necessities o
the case, but il has thus far been found that the
length OF time spent in these visits by the three or
duty amounts TO average Of about thirteen hour:
a day, or about four hours and half each.
-Four house physicians and two house surgeons
with medical assistant to each, have also beer
appointed, who reside on the island aud attend tc
the practice of the hospital, and the administration
Of medicines, under the direction of the visiting
| physicians and surgeons. They receive no emou'
ment other than board and washing, being selected
frop he hers m he
| however. graduates, and recommended 10 the Com
missioners by the medical board after exami nation
In addition to this arrangement for regular profes
sonal services, the experience of other hospital
recommended the appointment of some consulting
/ physicians and surgeons, gentlemen ct the hughes
standing and experience, upon whom the Commits
sioners or the medical board might rely for adyic,
when specially consulted. This was carried int
effect.
The system as above described, went into full
operation on the LIST September, 1850, and go far al
the experience Of nearly five months can test 1t
the expectations sentertanedlby most of the Com
misaioners have not been disappointed.
The comparison Of the returns Of the last fou
months Of 1850, with those Of the same period ir
1919, shows decrease in the proportion OF death.
of about one. sixth, there being no particular epi
demic prevailing at either period. This, however
may be the result Of circumstances other than the
change Of system.
1 A more satisfactory result has been presented tC
the Commissioners on the weekly visits of the
committees and the occssonl visits OF others o
them, in the generally improved appearance anc
service of the hospital warda, and particularly il
4 the great diminu,ion of oplhalmia, which haC
hitherto afflicted the emgrant children, and tn,
entire disappearance OF its more malignant form.
In connection with the subject of hospital pyac
uce, is proper to add that during the last autumn
certain charges were made, in some city papers, il
/ relation to post mortem examinations and dss sec
| tons These were examined by a committee o.
| this board, and afterwards by the grand jury.
In the opinion Of majority Of the committee
which was sustained by this board, these charge.
were either groundess or grossly exaggerated
| with the exception Of one act o.: some Of the
younger medical assistants. This was punished by
the dismissal or suspension Of the offenders.
by an arrangement with the New York Hospital
persons chargeable to this commission, taken Ill in
the night, or incapable from any sudden casually
OF being removed from the city, are received al
that institution, at the charge of the Commission
ere, for such time as the nature Of the case may