Art. VI.?-Statistics of the Barony Parish Fever Hospital of Glasgow in 1847-48. By James Paterson, House-Sur- v geon and Superintendent of the Hospital. During the year 1847, fever, which had for several months of the previous year assumed, in most parts of the country, an epidemic form, prevailed so much as to raise in the minds of all very considerable alarm. In Glasgow, the first noted increase of the disease was in autumn 1846, from which time it became more and more pre- valent, till it reached its maximum in the summer of the follow- ing year. The only public accommodation in this city, previous to 1847, was that afforded by the wards of the Royal Infir- mary, and in these the number of beds scarcely exceeded 200. As might have been expected, this amount of accommodation was found, even before the close of 1846, to be insufficient, accordingly, the managers of the Infirmary rented the Lock Hospital, then recently erected, and capable of affording ac- commodation to seventy or eighty persons. But as this auxi- liary hospital was too inconsiderable to render very efficient service in an increasing epidemic, the managers resolved that they should themselves build another on ground already in their possession; but so strong was the opposition of the neigh- bouring inhabitants and proprietors to this proceeding, that the design was relinquished. They then purchased a building in Bridgeton, one of the eastern suburbs of the city, but before it could be furnished to receive patients, opposition, as in the for- mer instance, was brought forward, and in such a way as to de- lay the employment of the building in the manner contemplated. 358 Mr Paterson's Statistics of the Barony Parish Urged by the increasing demand for accommodation, and the pos- sibility of their being obliged to quit the building they had rented, they reluctantly adopted a measure which they had previously re- jected, viz,, that of erecting on the Infirmary grounds a temporary shed. This was completed in June, and afforded accommoda- tion to 140 patients. At about the*same time, the Parochial Board of the City Parish, impressed with a conviction of the necessity of separating the sick from the healthy, obtained and fitted up the Old Town's Hospital for the accommodation of persons belonging to their own parish. They began to receive patients in the early part of July, and before long, their inmates numbered upwards of 600. With a similar feeling, and for a similar purpose, the Barony parochial authorities shortly afterwards made arrangements for the erection of a temporary hospital, the results of treatment in which, the details which follow are intended to illustrate. The wooden sheds first erected contained 150 beds, but the admissions were so numerous, that, a separate erection with 100 beds was soon afterwards added. The ground on which they were built was in the burgh of Anderston, one of the western suburbs of the city, and which forms part of the scattered parish, whose sick the hospital was to accommodate. There was already in exist- ence on the spot selected, a building which had formerly been occupied as a private residence, and which, although somewhat inadequate in culinary and other arrangements to the require- ments of an hospital, was found so far suitable for such purposes as to preclude the necessity of erecting any new building. The hospital was opened for the reception of cases on the 5th of August, and in ten days it was filled. Thus, from the be- ginning of autumn 1847, there were no fewer than three sepa- rate hospitals in Glasgow; and in the Royal Infirmary there was extra accommodation to the number of 140 beds. The epidemic was at this time rather on the decrease, yet the num- ber of patients in hospital, towards the close of August, and for some time subsequently, could not have averaged less than 1000. In the Barony Parish Hospital, the admissions, most numerous at its opening, decreased more or less rapidly till the middle of the present year, when the managers finding that accommoda- tion could now be obtained as formerly in the wards of the Royal Infirmary, and having got the sanction of the Board of Supervision to the conversion of the premises into a temporary hospital for paupers and those labouring under chronic diseases, thought it unnecessary to appropriate it longer to the reception of fever cases. Accordingly, after the 20th of June no cases of fever were admitted; and by the 5th of July, or eleven Fever Hospital of Glasgow in 1847-48. 359 months after the opening, the whole of the fever cases had been treated to a termination. With reference to the erection of such temporary buildings dur- ing the prevalence of an epidemic, and which can be made avail- able only while the epidemic lasts, the false economy of the mea- sure will be at once perceived by every one who reflects on the great cost of these erections, and their generally utter uselessness after the epidemic which called them into existence has passed away. In a city of such extent as Glasgow, with a population of upwards of 350,000, we need not expect to remain long free from epidemic visitations ; and although the permanent hospital accommodation already provided is amply sufficient during seasons of comparative healthfulness, its utter inadequacy dur- ing times of sickness, the past year, in common with many others, abundantly proves. What, then, can be said of the policy of remaining inactive until the tide of sickness and misery has risen with such overwhelming force as to render feeble and unavailing those efforts which, begun before its approach, might have warded off its severest shocks ? However much men may differ in their views as to the best mode of preserving the sana- tory condition of a large city, whether by small hospitals in each district, or by larger ones removed from the bulk of the people, there can be but one opinion regarding the propriety of effect- ing, by some method, the separation of the diseased from the healthy. Nothing contributes more to the spreading of any in- fectious epidemic than the crowding together of the healthy and the sick, even although filth and want of ventilation had no influence in its propagation. And are these influences wanting? The answer is found by ascertaining the state of the dwellings in the wynds, vennels, and almost interminable closes of the city and suburbs. In these, apartments of about eight feet by six, where ventilation is an impossibility, and where the light of heaven scarcely enters, have often to contain eight or ten indi- viduals, of both sexes and of all ages,?more frequently, too, belonging to four or five different families than to one. Disre- garding all other influences, and these are not few, one might be inclined to ask whether it be possible that, in such a place, one could become the subject of a contagious fever, and the rest escape. This is a subject which demands the highest attention of those who have control in such matters. To look at the subject only in a pecuniary point of view, what can be more opposed to the spirit of economy than, during a severe epidemic, to support at a great expense the poor in their own hovels?a system which tends directly to the increase of the disease?and, when its force has become almost spent, to erect, at a cost of some thousands of pounds, buildings which, when the rage of the disease has ceased, are all but useless ? It is a 360 Mr PutersorTs Statistics of the Barony Parish subject of much satisfaction, that the parochial authorities, both of the City and Barony parishes of Glasgow, have in contempla- tion the erection of hospitals in connection with workhouses, and in their near vicinity, which will be at all times ready to accommodate many hundreds of patients. With such means of speedy separation from the healthy of those that become the subjects of contagious disease, future epidemics will, in all pro- bability, be the cause of much less apprehension than hitherto. The statistical details which follow form a summary of a series of tables constructed on the plan adopted by Dr Orr, in his statistics of the Royal Infirmary of Glasgow for 1844, 45, and 46, successively, and which were published in this Journal, vol. lxviii. The number of patients admitted and treated to a termination during the eleven months that the building was occupied as a fever hospital, was 2639 ; of whom 1374 were males, and 1265 were females. Of this number, 303 died; and of these, 193 were males, and 110 were females ; so that, among the former the mortality amounted to 13*93 per cent., among the latter to 8*77, and among both to 11*48. It has been already men- tioned that the admissions were most numerous at the opening of the hospital, and that they became less each succeeding month. The number admitted during the first four months, (although in August the accommodation, compared with subse- quent periods, was only as 2 to 3), exceeded that during all the other months by 429; and the number admitted during December and January very nearly equalled that during the succeeding five months. The mortality also varied very con- siderably in the different months In August it was 16*39 per cent.; in September, October, and November it averaged 7*9; in December it rose to 22 39, falling in January to 10*5 ; thereafter the greatest was 15*1 in March, and the lowest 7*62 in April.