Guenter B. Risse. Hospital life in enlightenment Scotland. Care and teaching at the Royal Infirmary of Edinburgh. Cambridge: Cambridge University Press, 1986. xiv + 450 pp. $49.50 (cloth) (Reviewed by Alvin E. Rodin)
- Publisher
- John Wiley and Sons
- Year
- 1988
- Tongue
- English
- Weight
- 329 KB
- Volume
- 24
- Category
- Article
- ISSN
- 0022-5061
No coin nor oath required. For personal study only.
✦ Synopsis
The title of Guenter B. Risse's book does not do full justice to the breadth and detail of its content. It is and yet is more than a history of the first seventy or so years of a hospital that has had a considerable impact upon hospital care and clinical educationthe Royal Infirmary of Edinburgh, which opened its doors to patients in 1730. This long overdue comprehensive history of its origin provides insight into eighteenth-century concepts of diseases and management of specific patients. The extent and diversity of content exceeds that which one is accustomed to find in hospital histories, partly because of its restricted time frame.' Instead of extensive accounts of administrators, financial problems, and political machinations (although these are not neglected), the bulk of the work details the socioeconomic and cultural influences on diseases; and concepts, causes, manifestations, and treatment of the diseases as listed and described in various eighteenth-century records of the Royal Infirmary.
An integral part of Risse's work is the vital statistics that are available from the inception of the hospital. The General Register of Patients lists the name, age, sex, disease, and whether the patient was cured or died. There were few patients discharged as uncured as admissions were restricted to those with acute illness and, as suggested by Risse, there may have been creative accounting to impress subscribers of the hospital. Also available are the Prescription Book, the Admissions' Book with names of recommenders and reasons for admission or non-admission of patients and the Ward Ledger detailing daily patient activities. These resources are supplemented by fourteen student casebooks and student clinical lecture notes. Together they form a framework for the book and are used as the basis for more general discussions of eighteenth-century medicine and hospitals. Risse has also included a considerable amount of the data as tables which, in their totality, provide an unusually exhaustive and detailed orientation to many aspects of the Royal Infirmary 200 years ago-finances, diseases, patient demographics, sex distributions, specialty wards, lengths of stay, drugs, treatment regimens, teaching cases, and even autopsies.
The book does not follow the usual chronological pattern found in such works, the chapters being concerned with various aspects of hospital healers, care, patients, diseases, teaching, and organization. The first chapter begins with an account of a patient with typhus who was admitted in 1780 in a delirium and the last chapter ends with her discharge twenty-four days later, cured. Chapter 1 considers a variety of topics.
One of the prime motives for establishing a voluntary hospital for the sick poor was the desire to maintain a healthy work force for growing crops, production of goods,