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History of medical practice in Illinois - Bushnell Historical Society

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246 <strong>History</strong> <strong>of</strong> Medical Practice <strong>in</strong> Ill<strong>in</strong>oisIn 1903 the name <strong>of</strong> the <strong>in</strong>stitution was changed to Children's MemorialHospital.In the beg<strong>in</strong>n<strong>in</strong>g, the capacities <strong>of</strong> each <strong>of</strong> these worthy undertak<strong>in</strong>gswere extremely limited, but the foresight displayed and the unselfish enthusiasmput forth <strong>in</strong> behalf <strong>of</strong> both projects were forward steps whichshould not be forgotten <strong>in</strong> the history <strong>of</strong> pediatrics <strong>in</strong> Ill<strong>in</strong>ois.Dr. Isaac Abt's description <strong>of</strong> the Children's Ward <strong>in</strong> Cook CountyHospital is a picture <strong>of</strong> pediatrics <strong>in</strong> general dur<strong>in</strong>g the 1850-1900 period.The ward was established about 1885. "The ma<strong>in</strong> floor <strong>of</strong> the ward accommodatedthe older children while a sort <strong>of</strong> balcony or mezzan<strong>in</strong>e floorwas reserved for the <strong>in</strong>fants. . . . The section was not particularly welladapted for their welfare or their hygienic care. The ventilation was poor;cross <strong>in</strong>fections were a common occurrence and the management <strong>of</strong> theward strik<strong>in</strong>gly defective. . . . No special precautions were taken to preventhouse <strong>in</strong>fections or for secur<strong>in</strong>g the proper milk supply or for itspreparation for <strong>in</strong>fant use." The <strong>in</strong>fant death rate was very high, duechiefly to diarrhea or pneumonia or both.The writer, when a <strong>medical</strong> student after 1900, visited the Children'sWard at the Cook County Hospital and has a vivid recollection <strong>of</strong> its unsanitaryand unclean appearance. Had it not been for the contagious diseasepatients it might properly have been designated a pest house.In 1890, Michael Reese Hospital set aside a ward <strong>of</strong> 12 beds for the exclusivecare <strong>of</strong> children. Many <strong>of</strong> the private general hospitals, however,were slow to take this step. Even <strong>in</strong> the late 1890's, the pediatric departments<strong>of</strong> most <strong>of</strong> the large hospitals provided only a small number <strong>of</strong> cribsbecause the daily census for children was frequently <strong>in</strong>significant. It shouldbe remembered that dur<strong>in</strong>g this period the laboratory procedures rout<strong>in</strong>elyperformed were limited to ur<strong>in</strong>alyses and blood counts; blood transfusionsand <strong>in</strong>travenous fluids were given rarely and only <strong>in</strong> the face <strong>of</strong> impend<strong>in</strong>gdeath. A similar situation existed <strong>in</strong> respect to the adm<strong>in</strong>istration <strong>of</strong> oxygen,s<strong>in</strong>ce the oxygen tent had not yet come <strong>in</strong>to general use. Lumbarpuncture, which was <strong>in</strong>troduced by Qu<strong>in</strong>ke <strong>in</strong>1891, was rarely heard <strong>of</strong><strong>in</strong> Ill<strong>in</strong>ois dur<strong>in</strong>g the next ten years, and Roentgen did not discover thex-ray until 1895. Even blood pressures were seldom obta<strong>in</strong>ed. Under thesecircumstances, parents commonly felt that there was noth<strong>in</strong>g to be ga<strong>in</strong>edby hav<strong>in</strong>g a child hospitalized unless surgery was <strong>in</strong>dicated.Special nurseries for the newborn were equipped with few <strong>of</strong> the facilitiesadopted <strong>in</strong> later years. In the care <strong>of</strong> <strong>in</strong>fants more attention was given tothe antiseptic methods <strong>in</strong>troduced by Lister <strong>in</strong> 1865 than to <strong>medical</strong> asepsis.After the establishment <strong>of</strong> children's wards and <strong>in</strong>stitutions for their care,there was constant fear <strong>of</strong> the possibility <strong>of</strong> epidemics <strong>of</strong> vulvovag<strong>in</strong>itiswhich at that time were not <strong>in</strong>frequent. Gonorrheal <strong>in</strong>fections sometimes

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