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CITY OF BOSTON.
In Common Council, June 6, 1861. THE Joint Standing Committee on the Free City Hospital, would submit the following
Fully impressed with the importance of the subject submitted for their consideration, the Committee endeavored to procure all information within their reach to enable themselves to do it justice. They had frequent conferences with the Consulting Physicians, as also with other distinguished members of the faculty. To the City Physician they are indebted for much valuable advice in the prosecution of their labors, and the almoners of private charity throughout the city, well able from their position to judge of the necessity of another hospital, cheerfully gave us the benefit of their experience. His Honor the Mayor, among the earliest to realize the importance of such an institution to complete the golden circle of charities for which Boston is justly distinguished, has evinced much interest in our progress. From his able report, City Document 1857, No. 37, which presents an eminently complete view of the whole subject, we have derived both instruction and encouragement.
The preliminary question whether such an institution is a public necessity in Boston, has been elaborately discussed for the
last twelve years in the City Council, and so invariably decided in the affirmative, that we should not have felt called upon to take it again into consideration, but for certain opinions expressed by gentlemen connected with the Massachusetts General Hospital. We were permitted to examine carefully every part of their buildings, and from the physicians and others in attendance received full and explicit details of their arrangements and management. The annual reports of the trustees and superintendent present a comprehensive statement of their financial condition, and of the number, nationality, and social position of the patients treated. The impression left upon the minds of the Committee by the information obtained at the hospital and from these reports, was that all the accommodation needed by the community could be furnished there, were its income enlarged.
The expenses, last year, were as follows:
Stores, medicines, &c.
$ 19,360 43
$ 42,578 39
The aggregate number of patients admitted during the year 1860 was twelve hundred and forty, of whom about one thousand paid no compensation. The amount received from patients paying full or part board was $5,200. The average expense per week, for each patient, was $ 6.42. The annual income of the foundation applicable to the expenses of the hospital, exclusive of the board paid by patients, is not far from twenty thousand dollars, five thousand of which is from the Massachusetts General Hospital Life Insurance Company. Had it not been for an extra dividend the past year from the Life office of fifteen thousand dollars, one third of its accumulated earnings for the last five years, the expenditures would have exceeded the income.
There are in the hospital about two hundred beds. These are rather crowded, but the admirable system of ventilation and neatness, of quiet and order pervading every part of the establishment, prevent this becoming a serious evil. About one half of these beds are free, vested funds or annual subscriptions providing for their support. Nearly all of them are virtually so, the proportion of paying patients being not much more than one fifth of the whole that are at different times under treatment. The largest number of inmates at any one time in the hospital, was one hundred and seventy-five in the winter of 1860; the averarge during that year being one hundred and twenty-eight. The number of applicants refused admission was two hundred and forty-seven, of which seventy-four were cases of consumption. A large proportion of patients treated were from other places than the city of Boston. It is stated that last year no suitable applicant was refused admission, and that seventeen hundred could have been accommodated instead of twelve hundred and forty, had so many applied and the means at the disposal of the hospital authorized their reception.
We should have been discouraged by these representations from any further thought of another hospital in Boston, at the present time, had we found that they produced upon the minds of those better able to judge of their bearing on the question the same impression as upon our own. Each of the Consulting Physicians, with a full knowledge of these facts, was in turn requested to express his views as to the expediency of erecting a city hospital the present year, and without one dissenting voice, all were unanimous in the conclusion that it ought to be commenced without delay. And in this many other gentlemen interested in our public charities concurred. Various reasons were assigned why accommodations were needed not furnished by the Massachusetts Hospital or those at Rainsford or Deer Islands. The former make it a rule to admit 110 contagious or epidemic diseases, no cases of childbed or consumption, neither chronic nor incurable cases. Though munificently endowed and managed with the greatest wisdom and liberality for the purposes to which they profess to limit their action, the refusal to receive patients in former years, and the supposed difficulty of procuring admission for cases that would really be willingly received, have discouraged applications, and the numbers offering the past year afford no criterion of the extent of hospital accommodation actually needed. Numbers of the poor in miserable dwellings, domestices in out-of-the-way attics, strangers at hotels, are suffering from the want of proper care, who should find, within the walls of some hospital adapted to their condition and wants, comfortable and well ventilated apartments for their restoration. Twice, within the forty years it has been in existence, the presence of erysipelas or smallpox in its wards has rendered it necessary to close the hospital to new admissions, a few weeks, for its purification. If we possessed in Boston two institutions of the kind, or one provided like some of the puerperal hospitals abroad with two isolated buildings alternately used, this would have been attended with less serious consequences, since patients who should return to their homes under such circumstances would be very apt to carry with them the contagion. We have had more than once yellow fever among us, and Asiatic cholera, and that most fearful of maladies the smallpox, in its sporadic or epidemic form, is seldom absent, yet we have never had any proper place for the treatment of either. Other pestilential diseases, in forms more appalling than any heretofore known, may visit us and find us unprepared. It is true the Island hospitals answer very well in summer for many of these cases, but humanity shudders at the removal, in winter, of unfortunate victims of disease clinging to existence but by a thread, across six miles of ice-filled or storm-tossed waters, far beyond the reach or care of sympathizing friends.
Physicians in charge of these hospitals, speak feelingly of the numbers who are brought to them, for whom proper accommodations should be provided within the city limits.
Another consideration in favor of immediate action was not overlooked. Mr. Goodnow died in 1851, leaving property to the value of about twenty-five thousand dollars, to be invested for the purposes of a city hospital, to be located either in Ward Eleven or at South Boston, where he resided. Mr. William