Tue. Oct 26th, 2021

During the Crimean War, day hospitals were not so much centers of healing or recovery as they were where wounded fighters died somewhat slowly. Scooter Hospital in Turkey is one such infamous example. Transformed from an army barracks by the British Empire, the scooter lacked all the imaginary facilities, from basic sanitation to adequate ventilation, this “hospital” served as a powerful incubator for numerous infectious diseases – it was in Florence Nightingale and his Until.

Diseases of the Empire Jim Downs explores how many aspects of modern life are carried behind the most hateful emotions of humanity, although below, Downs explains how a woman’s relentless perseverance and cruel record helped to turn the field of resistance into resistance.

Belknap Press

Quoted from Maldives of the Empire: How Colonization, Slavery, and War Transformed Medicine Published by Jim Downs, Belknap Press of Harvard University Press. Used by Harvard College President and Fellows with copyright © 2021 permission. All rights reserved.

While on the scooter, Nightingale developed a record-keeping system that monitors various factors at Barrack Hospital and the nearby General Hospital. He took note of everything from the cleanliness to the amount of food, the latrines and the placement in the cemetery.

He also carefully examined the physical location. He took careful note of the size of the wards, the condition of the roof and the quality, size and placement of the windows. In his books on British military health, such as Thomas Trotter and others who wrote about the importance of fresh air, he pointed to the problem of inadequate ventilation and devoted an entire section to “bad ventilation.” He cited a report by the Sanitary Commission, which commented on the “poor condition of ventilation” at Barrack Hospital. There were “a few small openings here and there” so that there was no way for the “hot and dirty” air to escape. As a follower of the Miasma theory, he believed that diseases were spread through the air and advised ventilation to get rid of “polluted air” from the hospital.

In addition to inadequate ventilation, nightingale indicates poor drainage and poorly planned sewers and plumbing. In his deposition to the Royal Commission, Nightingale reported on the filthy condition he had learned of when he arrived at Barracks Hospital. “The state of privacy … for several months, more than an inch of dirty garbage, is horrible to describe.” He observed six dead dogs under a window and a dead horse lying in the water for weeks. The drinking water was dirty; Once he saw a hospital uniform used in a water tank. There were lots of rats and insects, and “the walls and ceiling were full of organic matter.”

Concluding his report on British Army health, he explained, “We have more information than any other about the sanitary history of the Crimean campaign, but it is the equivalent of a complete test (history does not carry). Disasters after relapse and due to negligence, remedies that have risen to a higher position of health and performance.

“It’s a whole test on a huge scale.” He noted that in the first seven months of the Crimean campaign, the death rate was higher than the plague of 1665, as well as the recent cholera epidemic. There was … the death rate among our patients is a little higher than that of our healthy guards. “

Using the war rate he collected during the war, including Civil War statistics, Nightingale showed that between 1839 and 1853 the death rate among soldiers was much higher than that of civilian men: “10,000 soldiers [at the age of 20]7 7,077 survive to 39 years of age, of whom 135 die at a later age; Whereas out of 10,000 civilians at the age of 20, 253 reached the age of 39 and 106 of them died the following year. ”Almost all the deaths among the soldiers were the result of disease; “The actual loss in war is a very small part of the catastrophe of a long war.” Nightingale classified the causes of death as “zymotic diseases” (which in the nineteenth century referred to infectious diseases such as fever, measles and cholera), “chest and tuberculosis” and “all other diseases (including violent death).” Nightingale criticized the army’s classification of diseases. At the bottom of a chart, he notes, “Bronchitis and influenza have no place in the Army’s nomenclature. The chronic cataract of Army Returns is really believed to be phthisis, in most cases; acute cataract epidemic cataracts, or both influenza and bronchitis.”

Nightingale presented statistics using charts, tables, and diagrams, which have just begun to appear in the research report, so that readers can easily imagine the comparison. He has created a new type of graphic, called the “Rose Chart”, also known as the Coxcomb Chart or Polar Area Diagram, to represent the death toll of the Crimean War. Each chart, which is laid out like a pie, shows one year of data, the slices representing the month. Each slice is divided into colored parts whose area is proportional to the number of deaths.

One part for traumatic death, the second for “preventable or mild gymotic disease” and the third for all other reasons. A quick look at the death charts from April 1854 to March 1855 and from April 1855 to March 1856 shows that there were far more deaths due to disease than war, and the overall death rate decreased in the second year.

To make the dangers of unhealthy hospitals more visible, Nightingale collected death data for matrons, nuns and nurses working at fifteen hospitals in London who died of “zymotic disease” of fever and cholera. She presented the table, which she noted William Farr compiled for her, showing that the death rate of nursing workers was much higher than the female population in London; In addition, women working in the hospital were more likely to die from gynecological diseases than other women. He used these figures to argue for “extremely important” hygiene in the hospital. “Loss of a well-trained nurse by preventable [sic] He wrote, “For the same reason, the disease is far more damaging than a good soldier. None of the money can replace it, but it is harder to find a good nurse than a good soldier.”

In his book Notes on Hospitals, he tells the story of a British prisoner of war who died in a crowded prison in India in 1556: . Nightingale’s reference to the case is proof of his status as a prototypical illustration of the need for ventilation. And what happened in India shows how the British medical authorities used information around the empire.

As a result of his work with a large number of patients in the Crimean War, Nightingale formulated his analysis as an epidemiologist in terms of population. He focused on how the disease spread within a group. He spent his energy not on changing bedpans or petting wounds, but on studying hospital structures, analyzing statistics, and figuring out how to increase ventilation.

The battle gave him the opportunity to compare mortality rates in different locations: crowded hospitals, dilapidated tents and wooden huts. It also highlights the importance of its preventive measures, one of the main principles of modern epidemiology. Revealing his observations, his insights and guidelines for hospitals to follow, he hoped to provide a rule and guideline for physicians to follow to prevent the spread of the disease. Although efforts to ensure proper hygiene as a means of preventing disease have been found in Mesopotamian civilization and Sanskrit texts since 2000 BC, especially Nightingale’s warnings and especially sanitary reforms, the mid-nineteenth century gave birth to a critical turn of the century. It transforms from an enterprise to a military transformer that focuses primarily on medical and surgical issues that begin to involve epidemiological questions and problems.

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