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Well, you are going to assume the fact that the water was shut off, also, I presume?
The WITNESS. Am I to assume that this is a first-class hospital?
À. I think it in admirable hospital for the purpose; but when you compare it with the Massachusetts General Hospital and say that it is a first-class hospital, I venture to differ. Q. Well, what do you mean by
- for the purpose"? dt. For the purpose of the sick poor of Boston to be taken care of there.
Q. Well, do you mean that the building is an admirable one ?
Q. In what respect do you consider the sick poor entitled to a different treatment from other poor - for instance, the people that go to the City Hospital of Boston ?
À. There are many that go to the City Hospital of Boston that do not belong to the pauper class.
Q. But in what respect are the poor to be treated differently from other people?
A. Poor people who are supported by tax-payers are not to be supported as expensively as a class of tax-piyers.
Q. Well, are all the people who go to the Massachusetts General Hospital treated for compensation or many of them without compensation ?
d. Many without.
Q. Do you make a distinction at the Massachusetts General Hospital in regard to the treatment of them?
A. Those who pay more have better facilities in the way of special nurses, and better rooms and luxuries.
Q. But otherwise than that, they are treated the same? They have the same cleanliness?
A. Yes, sir.
Q. They receive the attention of the same physicians — the physicians on the hospital staff'?
A. They all do.
Q. Are the women obliged to bathe in the open wards, without screens around them, because they are poor?
A. No, sir.
Q. You would not draw any of those distinctions between people who are poor and people who are not?
A. I would not.
Q. Well, returning to the question which I was about to put, assuming this report which Mr. Brown makes to be true, and which
Boston, February 28, 1894. To the Board of Ilealth :
GENTLEMEN : I have this day inspected premises at the hospital and institutions on Long Island, Ward 2, owned by city of Boston, and make the following report: The water-closets in the hospital, twelve in number, six for the females, and six for the males, are of the short hopper pattern with cistern and chain-pull attachment, and are located in five different parts of the building. These closets under favorable conditions, viz. : sufficient watersupply and care by those using them, would give fair satisfaction; but, owing to a break or stoppage in the water main, they have been without water since the 26th inst., except what has been carried in pails from the institution some distance away. Consequently, the surfaces of the lioppers have become dry and fæcal matter adheres to then, so that it is much more difficult to keep them clean than when the surfaces are wet. To-day one of them is obstructed and nine are unclean and offensire. The urinals would be in better condition if there was.a more generous supply of water. The sixteen water-closets in the institution are also of the hopper pattern with cistern and lever attachments operated by the doors. The closet rooms are without local ventilation except the windows, and considerable bad odor is noticeable on that account. These closets are also without water, and the three located in the basement are in about the same condition as those spoken of in the hospital, viz. : unclean and offensive.
Then follows his suggestions in regard to water. Now, doctor, assuming these facts to be correct, is that a condition in which you would hare a pauper institution ?
Mr. PRUCTOR. Read the rest of the report.
Mr. BRANDEIS. You may read the whole of it if you hare an opportunity.
Mr. PROCTOR. So that your hypothethical question will be in accordance with the facts.
Mr. BRANDEIS. – I wish you would.
Q. You would not. Then, I will read the rest of it, and then see whether that will make a difference. (Reading):
These closets are also without water, and the three located in the basement are in about the same condition as those spoken of in the hospital, viz. : unclean and offensive; the remainder are fairly clean. I have been informed by Dr. Jenks that there is it large cistern on the island having a capacity of 80,000 gallons, and that the water-boat will be at work to-morrow (Thursday) carrying water from Deer Island to fill it; this water will be pumped into the cisteriis in both buildings and supply the water-closets and urinals; if this is done most of the difficulty will be overcome until the water main is repaired. The remainder will be a matter of care.
Would you say now, even after you hare heard the rest of that statement, thit those closets, which he says are inclean and offensive, and which have no local ventilation, are such as you trould desire in i hospital for the poor?
. The lack of cleanliness of the closets I understand to be a liwek of water in the reservoir,
Mr. BRANDEIS. He dosen't say so.
Yes Mr. BRANDEIS. Why does he say, The remainder will be a matter of care”? He says that they are “ unclean and offensire," and that there is no local ventilation. Assuming this to be true, and the closets being situated as they are there alongside the hospitiil wards, would you think that closets without ventilation are such is even the poor of Boston should have?
The WITNESS. – I don't understand what is meant by ventilation of the closets. As I saw the closets, there were windows in that portion of the building in which these closets were. It seems to me it was quite possible to get ventilation by opening the window.
Q. Well, apparently he didn't think so. I'le is the city inspector. 1. Well, he may hiile it different view with reference to the ventilaHe says:
tion of a closet than I have. He may think that the water-closet itself should have a special ventilating system.
That I do not consider necessary — but that it is a matter of luxury.
Q. And do you think that those water-closets should he kept there in such close proxinity to the hospital, or that the patients there should have those odors around them?
A. There is an obvious cause for the odors there, as yo'ı have read the account; and that cause, I take it, was removed when the watersupply was introduced.
Q. Well, I think that perhaps if you had his report before you you would answer differently.
6. The closet-rooms are without local ventilation except the windows, and considerable bad odor was noticeable on that account." Now, it wasn't on account of the dirt, but the want or lack of ventilation.
A. I should assume it was on account of the windows being closed.
Q. Lon't you think that with the weather such as they might have there on that island on the 28th of February, there might have been some excuse for not having the windows open adjoining the closets ? Cannot you see that there might be objections on account of the draft?
A. If the draft were worse than the smell, of course the draft would be kept out.
Q. Don't you think that the poor are entitled to protection from both drafts and odors ?
A. Well, if they prefer warmth to the other inconvenience, they should not.
Q, Then you think it is proper not to have local ventilation for those closets ?
A. I can imagine circumstances under which it might be preferable.
Q. Well, do you want to say here, Dr. Fitz, that at the Massachusetts General Hospital you would subject the patients either to drafts or to odor's simply because they are poor?
A. Not because they are poor, but because they are patients in the hospital. It might be necessary.
Q. Well, why should it be necessary if you have local ventilation, and wliy cannot you have it?
A. You have the opportunity of local ventilation in the case which you presented to nie, but it isn't utilized.
Q. And you do think it proper, do you, that they should be subjected to these odors ?
A. Well, I can see circumstances under which it might be allowable.
Q, And you would say that in the Massachusetts General Hospital, in wards under your charge, they would subject patients because they are poor to drafts or odors in the same manner?
A. Not on the assumption “ because they are poor.”
Q. Is that the case in the Massachusetts General Hospital, that the patients, be they poor or rich, are subjected to the alternative of having the odors of closets or the crafts ?
A. It may be a question of a choice of evils.
Q. I want you to answer that question.
Q. Is it a fact that in the Massachusetts General Hospital the patients, be they poor or rich, are subjected to the alternative of having the odors of the closets, or drafts ?
A. Cases have occurred of that sort.
A. In any ward in the hospital which is in communication with the water-closets.
Q. Is there no other way of ventilating the water-closets but by the windows there?
A. There may be other ways. I don't know.
The WITNESS. With reference to the ventilation of water-closets, I understand that you desire an opinion.
Q. I asked you whether it is a fact that at the Massachusetts General Hospital, the patients there, be they rich or poor, are subjected to the alternative of either having drafts in the cold weather or having the bad odor from the water-closets ? If it is, I think we ought to start a subscription paper for the hospital immediately.
A. Very well, sir.
Q. Do you mean to say, Dr. Fitz, that the patients at the Massachusetts General Hospital are subjected to one or the other of those alternatives?
A. I mean to say that the closets in the Massachusetts General Hospital will at times create a stench which will require the opening of a window in their immediate vicinity to eliminate.
Q. Well, but he says that this is a constant fact down there. Isn't that so?
A. That I don't know.
Q. Well, I will read it to you again and will ask for your interpretation of it.
Ald. LEE. Why not let the doctor read it himself?
Mr. BRANDEIS —- I would be delighted to, if he wishes. (Reading): “ The closet-rooms are without local ventilation except the windows, and cousiderable bad odor was noticeable on that ilccount" account of the dirt, because the people at Long Island are more or less familiar with dirt, but because there was no local ventilation. Now, I want to ask you whether, at your Massachusetts General Hospital, that condition of things exists ?
4. I said that there was local ventilation in those closets, but it was not used.
Q. Then you deny the statement which Mr. Brown has made?
A. I deny that statement, that there was no local rentilation, if there Was it window there. The opportunity existed, and if there was none, it was because the window was not open.
Q. Do you know what provisions are required by law in regard to local ventilation ? a.
I do not. Q Of these rooms? 1. I do not.
Q. Well, now, as we are on this subject, I will ask you whether this condition which is reported by Dr. Harkius is one which you would approre of for the poor: 125 women in attics, ind no closet or sink
Mr. PROCTOR. What year is that?
Mr. BRANDEIS. - In January, 1892.
Q. (By Mr. BRANDEIS.) Is that a condition which you would approve of for the poor?
A. It is not. Q. It is not? d. No, sir.
Q. Now, here is another statement which he makes : “ To women in dormitories of white house,' and but one closet, and this latter also the only one available for women in sewing-room." Is that a condition which you would approve of for the poor?
A. It is not.
Q: Well, now, doctor, I will ask you this, whether in a hospital intended for the poor of the city of Boston that hospital is properly equipped without any weights or apparatus for weighing small powders
for weighing powders which come in large quantity, and are to be divided up and administered in small quantities, such as antipyrene, antifibrene, and sulphopal? Supposing there was no way by which powders that are bought in large quantities can be weighed. Is that good enough for the poor?
A. It is a question. Those medicines which you speak of there very often come in tablet form.
Q.. I asked you if it was properly equipped when they were brought in in large quantities?
A. They are not usually prescribed in that form.
Q. But supposing they come all together and that the nurses are to administer them?
A. They are not administered in that form.
Q. No; and that is the reason why I asked you whether a hospital that had no weights was well equipped, even for the poor?
A. If there were powders to be weighed and it made a difference in guessing as to whether one got a little more or a little less, undoubtedly scales should be provided, whether the patients were poor or rich.
Q. Do you think that this hospital was properly equipped if it is a fact that there were po small weights by which these powders could be weighed ?
Mr. PROCTOR. Are you reading that from the testimony?
Mr. BRANDEJS. – I am not reading that from the testinony, but I am reading it from facts which will be put in evidence.
The IVITNESS. - If powders were to be weighed and there were no means of weighing them, means should be provided for that pui pose.
Q And a hospital that did not have them would not be properly equipped ? A. In that respect; certainly not.
Q. Now, assuming the diseases there treated to be such as you have observed and such as you have seen indicated in the list there, would you say that a hospital was well equipped if it has no clinical thermometers ?
A. It is not well equipped for complete records of cases scientific observation of the cases.
Q. And you think, do you not, that even a hospital for the poor should have such scientific observation of cases ?
A. It depends altogether upon what the object of the hospital is. I can conceive that clinical thermometers might not be needed in a hospital for the rich.
Q. If you were superintendent of that hospital you would have them there, though, wouldn't you?